胸壁结核的CT诊断

CT diagnosis on tuberculosis of chest wall

目的探讨胸壁结核的CT表现及诊断。方法收集滨州市结核病防治院2002年11月—2009年3月期间的87例胸壁结核,全部病例经CT检查并手术病理确诊,15例做了增强扫描。结果(1)CT平扫表现为胸壁半圆形或扁平状软组织肿块影,边缘密度较高,中央密度较低,"哑铃状"中央低密度肿块较具有特征性CT表现。骨和关节破坏15例,肋骨局部皮质缺损样破坏9例,膨胀性溶骨性破坏3例;(2)增强扫描14例边缘强化,1例肿块内见多发低密度区,较平扫时显示更清晰。结论CT对胸壁结核的诊断及鉴别诊断有重要价值。

Objective To study the value of computed tomography（CT） scan in diagnosis of tuberculosis of chest wall. Methods All the 87 patients with chest wall tuberculosis in our hospital confirmed by postoperative pathohistology and received CT scan from November 2002 to March 2009,15 cases of them received contrast-enhanced CT scan. Results Plain CT scan appearances had semicircular or flat soft tissure masses with a high-density margin and low density center,dumb-bell shaped and low-density central masses.Bone and joint destruction were found in 15 cases,local rib cortex defect in 9 cases,expansile osteolysis in 3 cases;Contrast-Enhanced CT appearances had margin enhancement in 14 cases,heterogeneous low density masses in one case which was clearly in contrast-enhanced CT scan. Conclusions CT scan is the great clinical value in diagnosing and differentiating tuberculosis of the chest wall.