【摘要】 目的 探讨结核性腹膜炎的CT诊断价值。 方法 回顾性分析2009年10月-2010年7月22例经手术、病理或抗结核治疗确诊的结核性腹膜炎CT完整资料。主要观察:淋巴结、腹水、腹膜、系膜、网膜改变。 结果 淋巴结肿大12例，增强后呈“环状”强化改变。腹腔积液15例，少～中量12例，聚集在肠系膜根部、结肠旁沟及盆腔较多，CT值20～28HU。腹膜增厚16例，其中14例均匀光滑增厚，10例明显强化；大网膜增厚15例，其中饼状增厚2例、污垢样增厚9例、结节样4例。肠系膜增厚18例，3例肠袢聚集、粘连。伴有其他脏器结核13例。 结论 CT对诊断和鉴别诊断结核性腹膜炎具有较大的临床价值，结合临床多数结核性腹膜炎可作出正确诊断。
【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.
Citation：
CHEN Luning,LAI Jinzhong,LU Chunyan,LI Zhenlin,WANG Chenglong,WU Bing. CT Diagnosis and Differential Diagnosis of Tuberculotic Peritonitis. West China Medical Journal, 2010, 25(11): 2046-2048. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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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. 余日胜, 章伟敏, 李蓉芳. 结核性腹膜炎的CT表现及其病理学基础[J]. 中华结核和呼吸杂志, 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. 杨志刚, 李媛, 闵鹏秋, 等. 血行播散型与非血行播散型结核累及腹部淋巴结的CT强化表现及其解剖、病理基础[J]. 中国医学影像技术, 2005, 21(6): 927-930.
- 5. 全显跃, 梁文, 曾盛, 等. 结核性与癌性腹膜炎的CT鉴别诊断[J]. 中国医学影像学杂志, 1999, 7(3): 169-171.
- 6. 王之, 王康, 赵泽华, 等. 不同性质腹腔积液CT表现的分析探讨[J]. 放射学实践, 2008, 23(11): 1249-1252.
- 7. 董国礼, 雍良平. 结核性腹膜炎的CT表现及其病理学基础[J]. 实用放射学杂志, 2002, 18(11): 957-959.
- 8. 杨志刚, 闵鹏秋, 何之彦, 等. 腹腔和腹膜后间隙结核的CT表现及病理基础[J]. 中华放射学杂志, 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.
