女性盆腔结核的CT、MR表现

CT and MR manifestations of female pelvic tuberculosis

目的 探讨女性盆腔结核的CT、MR影像学特征。方法 回顾性分析8例经手术病理证实的女性盆腔结核的CT（n=6）和（或）MRI（n=5）表现。结果 7例有盆腔积液,积液CT值12~35 HU;2例为包裹性积液,1例为游离性积液,4例为包裹性、游离性积液并存。5例病变区钙化。7例呈双侧输卵管增粗、结节状改变。7例见盆腔包块,1例呈多分房囊性,1例呈实性,5例呈囊实性。4例网膜、系膜僵硬,部分呈饼状、索条状。7例与盆腔多个脏器粘连。5例淋巴结肿大、坏死。结论 盆腔结核影像学表现复杂,较高密度的腹腔积液、附件区钙化、实性成分增强延迟强化为其特异性表现。CT检查有利于高密度腹腔积液、钙化的检出;MR可显示包裹性积液的壁结构、输卵管增厚、结节,盆腔囊实性肿块的厚壁囊腔和盆腔内多发脏器粘连。CT与MR检查相结合有助于提高该病的诊断率。

Objective To explore CT and MRI features of female pelvic tuberculosis. Methods Retrospective analysis of 8 cases of female pelvic tuberculosis, which was confirmed by surgical pathology, and underwent CT （n = 6） or MR （n= 5） examinations, were performed. Results Seven cases were found pelvic cavity accumulates fluid which CT value was 12--35 HU; 2 cases were parcel effusion, 1 case was free effusion, 4 case were combined parcel and free effusion. Five cases were with calcifications. Seven cases were with bilateral oviduct thickening and nodular changes. Seven cases were with pelvic mass, and multilocular cystic was in 1 case, solid mass was in 1 case, cystic and solid masses was in 5 cases. Four cases were with retinal and mesangial thickening with pie or line strips. Seven cases were with multiple viscera adhesion in pelvic. Five cases were with lymph nodes enlargement, necro- sis. Conclusion The imaging findings of pelvic tuberculosis are complex. High density abdomimal cavity effusion, calcification of attachment area, delayed enhancement of its solid ingredients are specific performances. CT examination is helpful to find high density abdomimal cavity effusion and calcification; MRI has more advantages to display the capsule wall of parcel effusion, nodular or thickening oviduct, thick capsule wall of pelvic cystic or solid mass, multiple viscera adhesion in pelvic. Combination of CT and MRI is more helpful to improve its diagnostic rate.