CT平扫对结核性腹膜炎的诊断价值  

Value of plain CT scan for diagnosis of tuberculous peritonitis

作　　者：王孔林 马红霞[2] 张晓萍 张喆[2] 焦薇 陈忠元龙 綦迎成 郭佑民[2] 

机构地区：[1]新疆维吾尔自治区胸科医院,乌鲁木齐830049 [2]西安交通大学医学院第一附属医院影像科

出　　处：《中国防痨杂志》2012年第4期216-219,共4页Chinese Journal of Antituberculosis

摘　　要：目的探讨结核性腹膜炎的CT平扫表现特征。方法回顾性分析46例有CT扫描资料的结核性腹膜炎患者,其中经手术病理证实6例,腹腔穿刺证实2例,腹腔镜检证实4例,试验性治疗诊断34例。观察内容包括结核性腹膜炎累及壁腹膜、大网膜、肠系膜及腹膜后间隙的CT表现特征。结果 (1)壁腹膜增厚33例,其中均匀、光滑增厚27例,局部不规则增厚6例;(2)腹腔积液31例,其中20例为少量积液;(3)大网膜增厚26例,表现为污迹样增厚22例,饼状增厚2例;(4)肠系膜受累32例,其中9例合并小结节影:(5)淋巴结增大16例;(6)肠壁增厚1例,肠间距增宽2例。结论结核性腹膜炎CT平扫的主要表现有少量腹腔积液、均匀性腹膜增厚、大网膜污迹样增厚,以及肠系膜、肠管受累与腹腔淋巴结增大,CT平扫能为结核性腹膜炎的诊断提供重要信息。Objective To explore features of the plain CT scan in patients with tuberculous peritonitis. Methods Forty-six tuberculous peritonitis patients with data of abdominal plain CT scan were retrospectively re- viewed,including 6 cases proven by postoperation pathology, 2 cases diagnosed by abdominal puncture, 4 cases con firmed by laparoscopy, and 34 cases identified by experimental treatment. The CT features of tuberculous peritonitis involved in parietal peritoneun, peritonealcavity,greater omentum, mesentery, and.retroperitoneal space were ob- served. Results The main features in the plain abdominal CT scan of tuberculous peritonitis appeared as follows： ①Thickened parietal peritoneum in 33 cases （71.7 %）,including smooth in 27 and irregular in 6 ;②Ascites in 31 ca-ses （67.4%）, of which 20 cases revealed a small amount of effusion; ③Thickened greater omentum in 26 cases （47. 8 %）, including smear like shape in 22 and caked sign in 2 ; ④Mesenteric thickening in 32 cases （69.6%） with concurrent small nodular shadows in 9 cases;⑤Enlarged lymph nodes in 16 cases （34.8 %）. ⑥Bowel wall thickening in 1 case. Conclusion The main plain CT scan features of tuberculous peritonitis may appear as a small quantity ascites,smooth thickening and enhanced parietal peritoneum, thickened greater omentum with smear shadows, in- volvement of mesentery and enlargement of lymph nodes. The plain CT scan can provide important information for the diagnosis of tuberculous peritonitis.

关 键 词：腹膜炎 结核性/放射摄影术 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学] R526[医药卫生—临床医学]