胰腺结核的CT表现

CT manifestations of pancreatic tuberculosis

目的 探讨胰腺结核的CT表现及其诊断价值。方法 8例胰腺结核中 ,6例经手术病理证实 ,2例经穿刺活检证实 ,CT常规平扫加增强扫描。结果 多发结节型胰腺结核 1例 ,表现为肿大的胰腺内布满结节状低密度灶 ,仅结节灶边缘轻度强化。局灶型胰腺结核 7例 ,均累及胰头部。局部软组织肿块 4例 ,其中 2例伴有多发斑点状钙化灶 ,1例呈蜂窝状强化 ;囊性肿块 2例 ,其中 1例囊壁有多发斑点状钙化灶 ,另 1例为多房囊性病灶。胰头部团块状钙化灶 1例。8例胰腺结核中 4例有腹内胰外表现 ,包括腹内淋巴结结核、结核性腹膜炎 ,以及肝、脾结核。结论 胰腺结核CT表现呈多样化 ,但有一定特征性 ,伴有多发斑点状钙化灶或呈蜂窝状强化的胰腺肿块 ,可提示胰腺结核的诊断 ;

Objective To assess the CT manifestations and diagnostic value in the pancreatic tuberculosis(PTB)with review of the literatures. Methods All cases of PTB proved by surgery or biopsy were examined with plain and enhanced CT scans. Results The CT findings in one case with multiple nodular type of PTB were diffuse enlargement of the pancreas with multiple, nodular, and low density lesions; The nodular lesions had peripheral enhancement. 7 cases of local type of PTB encroached on pancreatic head. 4 cases showed local soft tissue masses with multiple flecked calcifications in 2 cases and mild enhancement in one case; Cystic masses was found in 2 cases, with mural calcification in 1 case and multiloculated cystic mass in 1 case, respectively; Massive pancreatic head calcification was demonstrated in one case. In these 8 cases of PTB, the lesion extended out of pancreas in 4 cases, including abdominal tuberculous lymph nodes, tuberculous peritonitis, and hepatosplenic tuberculosis. Conclusion CT findings of PTB were various but had some characteristics. Pancreatic masses with multiple flecked calcification or mild enhancement could suggest the diagnosis. Abdominal tuberculosis accompanied with the pancreatic lesion, especially tuberculous lymph nodes, was highly suggestive of the diagnosis of PTB.