肝脏结核的CT表现  

CT manifestations of hepatic tuberculosis

作　　者：邹高伟[1] 张亚林[1] 廖荣信[1] 

机构地区：[1]长沙市中心医院放射科,湖南长沙410004

出　　处：《中国现代医学杂志》2013年第36期81-86,共6页China Journal of Modern Medicine

摘　　要：目的分析肝结核的CT表现。方法回顾性分析33例经临床证实的肝结核CT表现特点,并作文献复习。结果①浆膜型3例:肝包膜增厚呈椭圆形稍低密度影,环形及分隔样强化,邻近肝实质受压并动脉期异常灌注。②实质型16例,其中:弥漫粟粒病灶5例:肝内弥漫粟粒状低密度影(大直径<10 mm),部分病灶门脉期轻度强化。多发多形病灶8例:多发大小不等、形态不同的病灶,低密度为主,不均强化,边缘性强化为主,大多门脉期比动脉期明显,部分病灶周围肝实质动脉期异常灌注,3例7个病灶内可见散在点状钙化。单发病灶3例:结节状、团块状,早期不均强化,延时环状或分房状强化。③混合型14例,同时合并浆膜结核及实质结核的CT表现。结论肝结核CT表现多样,但有定的特征性,结合肝外结核史、临床症状及相关性检查,可以明确诊断。肝实质型结核分为粟粒型、多灶多形型、单灶型较实用、合理。[Objective ] To improve the diagnostic CT hepatic tuberculosis. [Methods] CT findings of 33 pa- tients with hepatic tuberculosis were retrospectively analyzed, and a literature review. [ Results ] Hepatic serous type 3 cases were discovered whose abnormal imaging with liver capsule thickening oval slightly low density lesions, en- hancement to the ring and space sample strengthening, adjacent liver parenehyma pressureed and arterial perfusion abnormal, hepatic parenchyma type 16 casrs： militubercule type 5 cases with the small nodules of diffuse low density lesions. Part of the lesions portal vein period mild strengthening. Muhifocal pleomorphic type 8 cases with low densi- ty for multiple vary in size, and form different lesions. They are different degree strengthening, and part of the lesions peripheral parenchymal abnormal arterial perfusion. Single oven type 3 cases with performance for the nodular, or crumb lesions, which enhance to the early uneven strengthening, delay cricoid or rooming shape improved. Mixed type 14cases, showed both the liver and liver parenchyma type capsule 2 types performance. [ Conclusions ] Hepatic parenchyma tuberculosis could be classified into the three types： hepatic parenchyma militubercule type, hepatic parenchyma multifocal pleomorphic type, single focal hepatic parenchyma type. CT scanning can demonstrate some features of hepatic tubercubsis, there is very helpful in diagnosis and differential diagnosis.

关 键 词：结核 肝脏 体层摄影术 X线计算机 

分 类 号：R525[医药卫生—内科学]