多层螺旋CT对浆膜型肝结核的诊断价值探讨  

Diagnostic value of MSCT in serous Type hepatic tuberculosis

作　　者：丁勋[1] 徐佳[1] 鲁植艳[1] 龙清云[1] 周军[1] 

机构地区：[1]武汉大学中南医院影像科,湖北武汉430071

出　　处：《医学影像学杂志》2017年第7期1269-1272,共4页Journal of Medical Imaging

摘　　要：目的通过分析浆膜型肝结核的CT平扫及增强扫描表现,总结浆膜型肝结核的CT特点,提高对本病的认识。方法回顾性分析10例经穿刺活检、外科手术后病理证实的浆膜型肝结核患者的临床资料,观察其CT影像学特点。结果 CT平扫:10例患者共12个病灶,肝包膜均不同程度增厚,可表现为结节状;病灶呈类圆形、梭形及不规则形的囊性(n=6)、实性(n=3)及囊实性(n=3),可伴有钙化(n=2);病灶边缘可见环形壁(n=7),其中4个病灶内部可见分隔使病灶呈现多房状改变;12个病灶均不同程度压迫临近肝组织;病灶可累及周围结构(n=9),形成哑铃状或束腰状改变(n=2),并可形成窦道与体表相通(n=1)。CT增强扫描:8例患者共显示10个病灶,其中1例行动脉期、门脉期及延迟期三期扫描,7例行门脉期扫描。其中单环状强化(n=3),多房状强化(n=3),囊性改变(n=1);1例三期扫描为多房状强化病灶,环壁及分隔呈渐进性强化。结论浆膜型肝结核的CT表现有一定的特点,仔细分析CT平扫及增强扫描的特征,结合其临床表现,可以提高对此病诊断的准确率,为临床进一步治疗提供依据。Objective By analyzing findings of the serous type hepatic tuberculosis on the plain and enhanced CT scan, we summed up the CT characteristics of the disease so as to improve the understanding of this disorder.Methods A retrospective analysis of the clinical data of 10 patients with serous type hepatic TB confirmed by biopsy and pathology post-operation was conducted and CT imaging characteristics was observed.Results Plain CT scan： In ten patients, a total of 12 lesions were found.The liver capsule was all thickened to different extent and presented with nodular change.CT scan showed that the lesions appeared to be round, spindle and irregular cystic （n=6）, solid （n=3） and cystic solid （n=3） disease, accompanied with calcification （n=2）.The circular wall in the edge was visualized in 7 lesions, of which four presented with multilocular shape within the visible space.12 lesions compressed the near liver tissue in different degree.Lesions involved into the surrounding structure（n=9）, lesions constituted dumbbell or waist shape （n=2）.One lesion formed antrum, which was interlinked body surface.Enhanced CT scan： In 8 patients, a total of 10 lesions were revealed, 1 underwent arterial phase, portal phase, and delay phase scanning, 7 underwent portal phase scanning.There were unilocular reinforcements（n=3）, multi-loculated reinforcements （n=3）, and cystic lesion （n=1）.1 case underwent three-phase scan, the lesions presented with multi-loculated reinforcement, and the ring wall and separated part were gradually strengthening.Conclusion CT manifestations of serous type liver tuberculosis have certain characteristics.Careful analysis of the characteristics of the plain and enhanced CT scan, combined with its clinical manifestation, can improve the accuracy of diagnosis of this disease, thereby providing the basis for clinical treatment.

关 键 词：浆膜型 肝结核 体层摄影术 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]