摘要
目的分析肝结核的CT表现,探讨肝结核的CT诊断和鉴别诊断。方法回顾性分析18例有CT检查资料的肝结核,分析其影像学表现。结果18例肝结核中有12例合并腹腔或肺结核,结节型肝结核4例,可表现为肝内局灶性类圆形或不规则形低密度区,增强扫描无强化或仅有周边轻度强化;粟粒型肝结核12例,CT表现为肝弥漫性肿大、密度减低或表现为肝肿大伴有多发性粟粒状低密度灶,增强扫描无明显强化。混合型肝结核2例,表现为低密度灶和钙化斑点并存,其它类型罕见。结论粟粒型肝结核较小时CT常常难以显示,但肝肿大、肝CT值降低及无明显强化常见,结合结核病史或伴有其他脏器结核,应考虑到本病可能。“粉末”状钙化具有肝结核的诊断价值,结节型肝结核和结核性胆管炎的CT表现有一定的特征性。
Objective To evaluate the CT diagnosis of hepatic tuberculosis. Methods CT scan was performed in 18 patients with hepatic tuberculosis including miliary type and nodular type. Fifteen male and 3 female （mean 47 years） were all proved by biopsy or clinic. Literafures were reviewed . Results The CT findings were （ 1 ） Hepatic miliary tuberculosis （4 cases） showed diffuse enlargement of the liver with hypodensity or miliary low density foci in the liver. There were no enhancement following contrast injection. （2） Nodular type of hepatic tuberculosis （12 cases） showed focal low density lesion with peripheral enhancement after contrast administration. Some lesions （2 cases） demonstrated mixed density with central hyperdensity and powdery calcification and peripheral low density with an enhancing rim. Four were accompanied with tuberculous lesions of other visceral organs. Conclusions Diagnosis of hepatic miliary tuberculosis can hardly be made on CT appearances alone without a medical history of tuberculosis. Mixed type with powdery calcification and tuberculosis cholangitis has certain characteristic features, which are helpful to suggest the diagnosis.
出处
《现代临床医学生物工程学杂志》
2006年第5期409-412,共4页
Journal of Modern Clinical Medical Bioengineering
关键词
结核
肝
断层摄影术
X线计算机
Tuberculosis
Liver
Tomography, X-ray computed
