【摘要】 目的 探討結(jié)核性腹膜炎的CT診斷價值。 方法 回顧性分析2009年10月-2010年7月22例經(jīng)手術(shù)、病理或抗結(jié)核治療確診的結(jié)核性腹膜炎CT完整資料。主要觀察:淋巴結(jié)、腹水、腹膜、系膜、網(wǎng)膜改變。 結(jié)果 淋巴結(jié)腫大12例，增強后呈“環(huán)狀”強化改變。腹腔積液15例，少～中量12例，聚集在腸系膜根部、結(jié)腸旁溝及盆腔較多，CT值20～28HU。腹膜增厚16例，其中14例均勻光滑增厚，10例明顯強化；大網(wǎng)膜增厚15例，其中餅狀增厚2例、污垢樣增厚9例、結(jié)節(jié)樣4例。腸系膜增厚18例，3例腸袢聚集、粘連。伴有其他臟器結(jié)核13例。 結(jié)論 CT對診斷和鑒別診斷結(jié)核性腹膜炎具有較大的臨床價值，結(jié)合臨床多數(shù)結(jié)核性腹膜炎可作出正確診斷。
【Abstract】 Objective To evaluate the diagnostic value of CT scan for tuberculotic peritonitis. Methods The complete CT image data of 22 patients with tuberculotic peritonitis confirmed by surgical, pathologically, or therapeutic procedures from October 2009 to July 2010 were retrospectively analyzed. The changes of lymph nodes, ascites, thickened peritoneum, mesentery and greater omentum were observed. Results In 22 patients, enlargement and rim enhancement of lymph nodes were found in 12; ascites with CT value of 20-28 HU was in 15, of whom 12 had small or middle amount of effusion which located in mesentery or abdominal cavity; thickened parietal peritoneum was in 16, including smooth peritoneum in 14 and evident enhancement in 10; thickened greater omeutum was in 15, including cake-like thickening in 2, filth-like thickening in 9 and tuber-like thickening in 4; thickened mesentery was in 18, including intestinal loop adhesion in 3.A total of 13 patients were combined with other tuberculosis. Conclusion CT scan is very important in diagnosing and differentially diagnosing tuberculous perinitis.
引用本文： 陳路寧,賴盡忠,盧春燕,李真林,王成龍,伍兵. 結(jié)核性腹膜炎的CT診斷及鑒別診斷. 華西醫(yī)學(xué), 2010, 25(11): 2046-2048. doi: 復(fù)制
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- 1. Cakir B, Kirbas I, Cevik B, et al. Complications of continuous ambulatory peritoneal dialysis: evaluation with CT [J]. Diagn Inerv Radiol, 2008, 14(4): 212-220.
- 2. 余日勝, 章偉敏, 李蓉芳. 結(jié)核性腹膜炎的CT表現(xiàn)及其病理學(xué)基礎(chǔ)[J]. 中華結(jié)核和呼吸雜志, 2002, 25(4): 243-244.
- 3. Capron J, Lafont C, Gratea G, et al. Non-invasive diagnosis of peritoneal tuberculosis[J]. Rev Med Intern, 2010 May 31. [Epub ahead of print].
- 4. 楊志剛, 李媛, 閔鵬秋, 等. 血行播散型與非血行播散型結(jié)核累及腹部淋巴結(jié)的CT強化表現(xiàn)及其解剖、病理基礎(chǔ)[J]. 中國醫(yī)學(xué)影像技術(shù), 2005, 21(6): 927-930.
- 5. 全顯躍, 梁文, 曾盛, 等. 結(jié)核性與癌性腹膜炎的CT鑒別診斷[J]. 中國醫(yī)學(xué)影像學(xué)雜志, 1999, 7(3): 169-171.
- 6. 王之, 王康, 趙澤華, 等. 不同性質(zhì)腹腔積液CT表現(xiàn)的分析探討[J]. 放射學(xué)實踐, 2008, 23(11): 1249-1252.
- 7. 董國禮, 雍良平. 結(jié)核性腹膜炎的CT表現(xiàn)及其病理學(xué)基礎(chǔ)[J]. 實用放射學(xué)雜志, 2002, 18(11): 957-959.
- 8. 楊志剛, 閔鵬秋, 何之彥, 等. 腹腔和腹膜后間隙結(jié)核的CT表現(xiàn)及病理基礎(chǔ)[J]. 中華放射學(xué)雜志, 1996, 30(3): 155-158.
- 9. Mazxzie JP, Wilson SR, Sadler MA, et al. Imaging of gastrointestinal tract infection[J]. Semin Roentgenol, 2007, 42(2): 102-116.
- 10. Akpolat T. Tuberculous peritonitis[J]. Perit Dial Int, 2009, 29 (Suppl 2): 166-169.
- 11. Chong VH. CT findings of tuberculous peritonitis[J]. Singapore Med J, 2009, 50(6): 647-649.