结核性腹膜炎和癌性腹膜炎的CT征象对比分析

Comparative analysis of CT feature of tuberculous peritonitis and cancerous peritonitis

目的对比分析结核性腹膜炎(tuberculous peritonitis,TBP)和癌性腹膜炎(cancerous peritonitis,CP)的各种CT表现特征,探讨各种CT征象的诊断价值。方法回顾性分析31例TBP和37例CP患者的CT征象,采用χ2检验对比各种CT征象在两种病变中的发生率,并和病理及临床结果进行对比分析。结果 31例TBP患者中,CT正确诊断27例,误诊4例,误诊率为12.90%(4/31)。37例CP患者中,CT正确诊断31例,误诊6例,误诊率为16.22%(6/37)。各种CT征象中,腹腔原发肿瘤病灶、肝脏转移灶或门静脉癌栓只出现在CP组,腹腔淋巴结钙化只出现在TBP组。小网膜囊积液、肠系膜小点状或絮状增厚,两组比较差异无统计学意义(P>0.05);腹膜增厚形态及强化、腹腔淋巴结分布及强化形式、腹腔积液量大网膜饼状增厚、囊状改变,两组比较,差异有统计学意义(P<0.05)。结论正确认识TBP和CP的各种CT征象对两种病变的诊断和鉴别诊断有重要价值。

Objective To compare and analyze the various computed tomography （CT） feature of tuberculous peritonitis （TBP） and cancerous peritonitis （CP）, and explore the diagnostic value of CT signs. Methods Retrospective analysis of CT signs was conducted on 31 patients with TBP and 37 patients with CP.x2 test was adopted to compare the incidence rate of CT signs in the two kinds of disease, and compare with the pathological and clinical results analytically. Results Among the 31 pa- tients with TBP,27 cases correctly diagnosed by CT and 6 cases were misdiagnosed with the misdiagnosis rate of 12.90% （4/31）. Among 37 patients with CP, 31 got correctly diagnosed by CT and 6 misdiagnosed with the misdiagnosis rate of 16.22% （6/37）. In various CT signs,primary tumor lesions in abdominal cavity,liver metastasis or portal vein tumor thrombus only appeared in the CP group, and the abdominal lymph node calcification only in the TBP group;the difference between the two groups on the lesser omentum sac effusion, the mesenteric small dot and flocculent structure incrassation had no statistical significance （P〉0.05） ;the difference between the two groups on peritoneum incrassation morphology and intensity, celiac lymph nodes distribution and in tensity, seroperitoneum volume, great omentum incrassation and cystic airspaces change was statistically significant （P〈0.05）. Con- dusion It is of great value to understand CT features of TBP and CP correctly in diagnosis and identification of the two diseases.