多层螺旋CT对于肝结核的诊断价值  

Value of Multislice Spiral CT Scanning in Diagnosing Hepatic Tuberculosis

作　　者：李迎春[1] 宋彬[2] 吴苾[2] 徐隽[3] 蒋瑾[1] 印隆林[1] 

机构地区：[1]四川省医学科学院.四川省人民医院放射科,成都610072 [2]四川大学华西医院放射科,成都610041 [3]四川省第四人民医院放射科,成都610016

出　　处：《中国普外基础与临床杂志》2008年第11期863-867,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨肝结核的多层螺旋CT表现及其诊断价值。方法收集14例经手术(5例)、穿刺活检(4例)或临床(5例)证实的肝结核患者CT资料,分析其CT表现,并与病理改变对照。结果14例肝结核可分为2种类型:①肝实质型12例。细分为4种亚型:粟粒型2例,增强扫描表现为点状稍低密度;结节型5例,平扫边界模糊,有2例环形强化,2例无强化,1例环形强化与无强化区混杂;脓肿型4例,平扫边界模糊,2例表现为云絮状淡薄强化,2例环形强化;纤维钙化型1例,钙化灶呈斑块状。②肝浆膜型2例,表现为肝包膜均匀性增厚或伴结节附着,呈轻微强化,肝包膜下局限积液。其他征象包括肝肿大和其他器官结核,如腹腔淋巴结、胰、脾、肾上腺、肠道及肺部可见结核病灶。结论螺旋CT对诊断肝结核有重要价值,一定程度上反映了肝结核不同的病理改变。Objective To investigate the value of multislice spiral CT （MSCT） findings in the diagnosis of hepatic tuberculosis. Methods MSCT imaging data, including both plain and contrast-enhanced CT scan, of 14 patients with hepatic tuberculosis confirmed by surgery （5 patients）, aspiration biopsy （4 patients）, or clinic follow-up （5 patients） were collected for the study. MSCT findings were analyzed with correlation of pathological changes. Results Hepatic tuberculosis was classified into 2 types. （1）The parenchymal type （12 patients）, which was further divided into 4 subtypes： Miliary subtype （2 patients） showed multiple tiny hypodense dots with faint border and had no enhancement; Nodular subtype （5 patients） showed blurring border on plain CT scan, 2 patients had no enhancement, 2 had peripheral rim-like enhancement, and peripheral rim enhancement mixed with no enhancement in 1 patient; Abscess subtype （4 patients） showed central hypodense area with peripheral zone-like enhancement in 2 pa tients, or patchy like slight enhancement in 2 patients; Fabric and calcific subtype （1 patient） depicted enplaque cal cification. （2）The serohepatic type （2 patients） showed thickened hepatic capsule, sub-capsule nodules with slight enhancement, and local subcapsular fluid collection. Other signs included hepatomegaly, tuberculous lymphadenopa- thy, splenic tuberculosis, and tuberculosis of pancreas, adrenal glands, intestine and thorax. Conclusion MSCT plays an important role in diagnosis of hepatic tuberculosis, by reflecting underlying pathological changes.

关 键 词：结核 肝 断层摄影术/X线计算机 

分 类 号：R525[医药卫生—内科学] R814.42[医药卫生—临床医学]