胆囊结核CT、MRI表现

CT and MRI manifestations of gallbladder tuberculosis

目的分析胆囊结核的CT、MRI表现,提高对本病的认识和影像诊断水平。方法收集、分析经临床病理证实的5例胆囊结核(gallbladder tuberculosis,GT)的CT、MRI表现。5例均CT平扫,其中增强扫描2例;1例进行CT扫描的同时进行MRI扫描。结果 CT平扫:胆囊壁增厚,囊内密度均匀或不均匀,与肝脏边界清晰或模糊;增强扫描胆囊壁轻度强化,囊内可见分隔状强化影。MRI平扫:胆囊区见卵圆形异常信号,病灶中央呈稍短T1、长T2信号,周围环绕带状短T1、短T2信号,其外层见半环状稍短T1、长T2信号。胆囊结核的平扫表现(病变形态、大小、边缘、密度及信号)、增强(强化程度、方式)等特征有助于其诊断与鉴别诊断。结论部分GT具有一定特征性的CT、MRI表现,结合相关临床资料,可在术前做出正确诊断,为临床诊断、治疗及预后判断提供理论依据。

Objective To improve the understanding and diagnostic level of the gallbladder tuberculosis(GT)by analyzing its CT and MRI findings.Methods CT and MRI findings of 5 patients with GT proved by clinical pathology were collected and analyzed.CT scan was performed in 5 cases,including enhanced scan in 2 cases,and both CT scan and MRI scan were carried out in 1 cases.Results CT scan showed that the gallbladder wall was thickened,the density of the cyst was uniform or non-uniform,and the boundary of the gallbladder was clear or vague.The enhancement of the gallbladder wall was slightly enhanced,and the enhancement was seen in the capsule.As to MRI scan,ovoid abnormal signal was noticed in the gallbladder area,central lesions showed slightly short T1 and long T2 signals while surrounded lesions showed strip-like short T1 and short T2 signal,and slightly shorter T1,T2 signals with half ring shape were found in the outer sphere.The features of gallbladder tuberculosis,such as the shape,size,edge,density and signal of the lesion,and the degree of enhancement are helpful for differential diagnosis.Conclusion GT may has some specific CT and MRI characteristics,which facilitate to make a correct preoperative diagnosis,especially combined with relevant clinical data,and provide a theoretical evidence for clinical treatment and prognosis.