输卵管结核伴结核性腹膜炎的CT诊断  

CT diagnosis of tuberculosis of fallopian tube with tuberculous peritonitis

作　　者：张兰芳[1] 沈文荣[1] 郭震[1] 康铮[1] 王美芹[1] 

机构地区：[1]江苏省肿瘤医院CT室,南京210009

出　　处：《放射学实践》2011年第12期1266-1269,共4页Radiologic Practice

基　　金：江苏省肿瘤医院青年科技基金项目(ZQ200807)

摘　　要：目的:探讨输卵管结核伴结核性腹膜炎的CT特征,提高诊断准确性。方法:回顾性分析15例经病理或抗结核治疗确诊的输卵管结核伴结核性腹膜炎患者的CT表现。结果:双侧附件区病变14例,单侧1例,共29侧病灶。典型的输卵管异常12侧,增粗强化5侧,管壁增厚伴管腔扩张7侧(腊肠状)。附件区肿块14侧;附件区片絮状强化灶3侧。13侧病灶境界不清,与邻近结构有粘连。腹膜增厚13例,其中11例呈均匀增厚、明显强化,2例呈不均匀增厚。大网膜增厚13例,其中污垢状增厚9例,网状增厚3例,实性网膜饼1例;6例可见网膜线。肠系膜受累12例。盆腹腔广泛粘连7例。腹水15例,其中高密度腹水9例(CT値>20HU),包裹性6例。淋巴结肿大11例。结论:增粗或腊肠状输卵管、附件区不均质肿块结合腹膜均匀增厚、网膜线、高密度和/或包裹性腹水、盆腹腔广泛粘连等多个征象有助于输卵管结核伴结核性腹膜炎的诊断。Objective：To evaluate CT features of tuberculosis of fallopian tube（TFT） with tuberculous peritonitis（TBP）.Methods：CT findings of TFT with TBP proved pathologically or clinically in 15 cases were analyzed retrospectively.Results：Bilateral lesions in the adnexal regions were found in 14 cases and unilateral lesion in 1 case,totally 29 sites.Typical abnormality of fallopian tubes occurred in 12 sides,thickened and enhanced fallopian tubes in 5 sides,thick-walled cystic dilatation（sausage-shaped） of fallopian tubes in 7 sides.There were heterogeneous adnexal masses in 14 sides.Tumor-like flakes were found in 3 sides.Lesions with indistinct margins presented adhesion with adjacent structures in 13 of 29 sides.The peritoneum was uniformly thickened and markedly enhanced in 11 cases and irregular thickness in 2 cases.Smudged omentum was noted in 9 cases,reticulate thickening in 3 cases and solid omental cake in 1 case.Omental line was noted in 6 cases.Infiltration of the mesentery was observed in 12 cases,massive adhesion in the abdominopelvic cavity in 7 cases.Ascites presented in all of the 15 cases,of which high density ascites in 9 cases and encapsulation in 6 cases.Lymphadenopathy was observed in 11 cases.Conclusion：Abnormality features in the adnexal regions such as thicked or sausage-shaped fallopian tubes,heterogeneous masses combined with uniformly thickened peritoneum,omental line,high density /encapsulated ascites and massive adhesion in the abdominopelvic cavity can do help to the diagnosis of TFT with TBP.

关 键 词：输卵管 腹膜炎 结核性 体层摄影术 X线计算机 

分 类 号：R527.4[医药卫生—内科学] R526[医药卫生—临床医学]