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目的研究腹腔及腹膜后间隙淋巴结结核的多层螺旋CT强化特征,以提高该疾病的影像诊断水平。方法收集本院经临床病理证实的腹部淋巴结结核19例,在多层螺旋CT强化图像上,观察受累淋巴结的大小、形态、密度、强化类型、优势解剖分布以及淋巴结外器官病变的强化特征。结果94.7%淋巴结结核呈典型的环状强化,仅5.3%增大的淋巴结呈均匀强化。腹部淋巴结结核常优势地累及肠系膜(73.7%)、门腔间隙(63.2%)、肝十二指肠韧带(57.9%)、肝胃韧带(47.4%)和腹主动脉周围上部淋巴结(47.4%)。9例(47.4%)脾增大,其中5例(26.3%)脾内有多发低密度灶,病灶周边强化;6例(31.5%)腹腔积液;3例(15.8%)大网膜、肠系膜和壁层腹膜广泛结节样增厚。结论结核累及腹腔及腹膜后间隙淋巴结的多层螺旋CT强化具有一定特征。
Objective To study the multi-slice spiral CT features of peritoneal and retroperitoneal lymph nodes in order to improve the imaging diagnosis of this disease. Methods Nineteen patients with clinically and pathologically confirmed nodal lymph node tuberculosis in our hospital were collected. The size, shape, density, type of enhancement, dominant anatomic distribution and enhanced features of extranodal lymph nodes were observed on multislice spiral CT images. Results 94.7% of lymph node tuberculosis showed a typical ring enhancement, only 5.3% of the enlarged lymph nodes were uniformly enhanced. Abdominal lymph node tuberculosis often predominantly affects the mesentery (73.7%), the glenoid space (63.2%), the hepatoduodenal ligament (57.9%), the liver and gastric ligament (47.4%) and the upper abdominal aorta lymph nodes (47.4% . Nine cases (47.4%) had splenomegaly. Among them, 5 cases (26.3%) had multiple low-density lesions in the spleen with enhanced peri-lesion. Six patients (31.5%) had ascites, three Extensive nodular thickening of parietal peritoneum. Conclusion tuberculosis involving the peritoneal and retroperitoneal lymph nodes multi-slice spiral CT enhancement has some characteristics.