肿瘤性与结核性腹腔积液CT鉴别征象探讨  

Discussion of the CT differential diagnosis between the tumor and tuberculous ascites

作　　者：谭书德[1] 池祥波 李恩春[1] 刘敏[1] 李瑾[3] 

机构地区：[1]重庆市綦江区人民医院CT室 [2]重庆市綦江区人民医院心内科 [3]重庆市綦江区人民医院检验科,重庆401420

出　　处：《川北医学院学报》2016年第5期737-740,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨从CT征象上鉴别肿瘤性与结核性腹腔积液。方法:收集本院2011年1月至2013年12月经过CT扫描并经病理学证实的腹腔积液患者60例,回顾性分析其CT表现。结果:(1)结核性腹腔积液为少至中量者占91.3%(21/23);肿瘤性腹腔积液为中至大量者占91.9%(33/37),组间差异有显著性意义;(2)结核性腹腔积液CT值>20 Hu(18/23)占78.3%,结核性CT值>20 Hu占18.1%(7/37);组间差异有显著性。(3)结核性腹腔积液的腹膜呈线带状增厚占74.0%(17/23),肿瘤性腹腔积液的腹膜呈不规则和结节状增厚伴轻度或无强化占78.4%(29/37);组间差异有显著性。(4)网膜或系膜呈团片状、污垢状改变结核腹腔积液占74.0%(17/23),大网膜增厚、粘连程度较重呈饼状改变肿瘤性腹腔积液占73.0%(27/37);组间差异有显著性。(5)肠系膜淋巴结环状强化及钙化,结核性腹腔积液分别47.8%(11/23)、56.5%(13/23),肿瘤性腹腔积液分别为8.1%(3/37)、5.4%(2/37);组间差异有显著性。(6)结核性腹腔积液肠管漂浮与聚集征占69.6%(16/23),肿瘤性腹腔积液肠管放射状排列占45.9%(17/37);组间差异有显著性。结论:通过一些CT征象的仔细观察分析,有助于肿瘤性与结核性腹腔积液的鉴别。Objective： To identify neoplastic and tuberculous peritoneal effusion from CT signs. Methods： The CT performances of 60 patients with peritoneal effusion proved by pathology who were hospitalized from January 2011 to December 2013 were retrospectively analyzed. Results：（ 1） Little to medium amount of peritoneal effusion accounted for 91. 3% of all tuberculous cases（ 21 /23）;Medium to large amount of peritoneal effusion accounted for 91. 9% of all neoplastic cases（ 33 /37） There was a significant difference between the groups.（ 2） In terms of CT value,78. 3% of all cases were greater than 20 Hu（ 18 /23）; In terms of CT value,81. 1% of all cases were less than 20 Hu（ 30 /37）; There was a significant difference between the groups.（ 3） Thickened peritoneum accounted for74. 0% of all tuberculous peritoneal effusion cases（ 17 /23）; The irregular or tubercular thickening of peritoneum with no or little enhancement accounted for 78. 4% of all neoplastic peritoneal effusion cases（ 29 /37）; There was a significant difference between the groups.（ 4） The mass-like or smudged change of omentum and mesentery accounted for 74. 0% of all tuberculous peritoneal effusion cases（ 17 /23）; The omentum change with pancake thickening and serious adhesion accounted for 73. 0% of all neoplastic peritoneal effusion cases（ 27 /37）; There was a significant difference between the groups.（ 5） The percentages of lymph nodes with ring-like enhancement and calcification in the mesenter to tuberculous peritoneal effusion cases were 47. 8%（ 11 /23） and 56. 5%（ 13 /23） respectively.In the same way,their percentages to neoplastic peritoneal effusion were 8. 1%（ 3 /37） and 5. 4%（ 2 /37） respectively; there was a significant difference between the groups.（ 6） The floatation or aggregation of intestina accounted for 69. 6% of all tuberculous peritoneal effusion cases（ 16 /23）; The radial distribution of intestina accounted for 45. 9% of all neoplastic peritoneal effusion

关 键 词：结核性 肿瘤性 腹腔积液 CT征象 

分 类 号：R730.4[医药卫生—肿瘤]