肠结核的X线钡剂造影及CT影像表现  

Intestinal tuberculosis:X-ray barium meal radiography and CT imaging findings

作　　者：王正元 刘衡 鲁宏[2] Wang Zhengyuan;Liu Heng;Lu Hong(Department of Radiology,the Affiliated Hospital of Zunyi Medical University,Guizhou Zunyi 563003,China;Department of Radiology,the Seventh People's Hospital of Chongqing,Chongqing 400054,China)

机构地区：[1]遵义医科大学附属医院影像科,贵州遵义563003 [2]重庆市第七人民医院影像科,重庆400054

出　　处：《新发传染病电子杂志》2020年第4期265-267,共3页Electronic Journal of Emerging Infectious Diseases

基　　金：国家自然科学基金项目(81160181);重庆市自然基金,重庆市科技局项目(cstc2019jcyj-msxmX0353)。

摘　　要：目的分析肠结核(ITB)的X线钡剂造影表现及CT表现,提高对本病的认识和影像诊断水平。方法回顾性分析经临床病理证实的10例ITB的X线钡剂造影表现及CT表现,其中2例行CT平扫,4例行CT平扫+增强扫描+X线钡餐造影,2例行小肠钡剂造影,2例行钡灌肠大肠造影。结果①溃疡型ITB8例,其中4例胸部CT发现肺结核,X线钡剂造影回盲部肠表现为多发小溃疡,肠管局部狭窄;2例X线钡剂造影表现为回肠末端瘘管形成,钡剂外溢;2例腹部CT平扫“未见异常”,X线钡剂造影表现为回盲部“跳跃征”。②增生型ITB2例,其中1例空肠结核合并肠梗阻;1例升结肠、横结肠结核,出现分层现象,表现为“靶征”和“双环征”。结论大部分ITB的CT、X线钡剂造影表现具有一定特征性,结合相关临床资料,可在术前做出正确诊断,可为治疗及预后判断提供相关参考。Objective To improve the understanding and diagnostic level of the intestinal tuberculosis(ITB)by analyzing its X-ray barium meal examinations and CT findings.Methods X-ray barium meal examinations and CT findings of 10 patients with ITB proved by clinical pathology were collected and analyzed.CT scan was performed in 2 cases,and both CT scan,CT enhanced scan and X-ray barium meal examinations were carried out in 4 cases.Small intestine radiography was carried out in 2 cases.Large intestine radiography was carried out in 2 cases.Results①Ulcerated intestinal tuberculosis:8 cases.Four cases of pulmonary tuberculosis and intestinal tuberculosis were characterized by multiple small ulcer and local stenosis.Two cases of intestinal tuberculosis were accompanied with fistula formation,which were characterized by terminal ileum fistula and barium spillover.Abdominal CT findings of two cases were normal,but X-ray barium meal radiography were presented as intestinal tuberculosis.②Proliferative intestinal tuberculosis:2 cases.One case of intestinal tuberculosis was accompanied with intestinal obstruction.One case of ascending colon and transverse colon tuberculosis,appeared as stratified phenomenon of"target sign"and"double loop sign".Conclusion Most ITB may have some specific CT and X-ray characteristics,which facilitate to make a correct preoperative diagnosis,especially combined with relevant clinical data,and provide theoretical evidence for clinical treatment and prognosis.

关 键 词：肠结核 结核分枝杆菌 体层摄影 钡餐造影 X线计算机 

分 类 号：R524[医药卫生—内科学]