Objective To investigate the value of multislice spiral CT （MSCT） findings in the diagnosis of hepatic tuberculosis. Methods MSCT imaging data, including both plain and contrast-enhanced CT scan, of 14 patients with hepatic tuberculosis confirmed by surgery (5 patients), aspiration biopsy (4 patients), or clinic follow-up (5 patients) were collected for the study. MSCT findings were analyzed with correlation of pathological changes. Results Hepatic tuberculosis was classified into 2 types. ①The parenchymal type (12 patients), which was further divided into 4 subtypes: Miliary subtype (2 patients) showed multiple tiny hypodense dots with faint border and had no enhancement; Nodular subtype (5 patients) showed blurring border on plain CT scan, 2 patients had no enhancement, 2 had peripheral rim-like enhancement, and peripheral rim enhancement mixed with no enhancement in 1 patient; Abscess subtype (4 patients) showed central hypodense area with peripheral zone-like enhancement in 2 patients, or patchy like slight enhancement in 2 patients; Fabric and calcific subtype (1 patient) depicted enplaque calcification. ②The serohepatic type (2 patients) showed thickened hepatic capsule, sub-capsule nodules with slight enhancement, and local subcapsular fluid collection. Other signs included hepatomegaly, tuberculous lymphadenopathy, splenic tuberculosis, and tuberculosis of pancreas, adrenal glands, intestine and thorax. Conclusion MSCT plays an important role in diagnosis of hepatic tuberculosis, by reflecting underlying pathological changes.
Citation：
LI Yingchun,SONG Bin,WU Bi,XU Juan,JIANG Jin,YIN Longlin. Value of Multislice Spiral CT Scanning in Diagnosing Hepatic Tuberculosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(11): 863-867. doi:
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- 1. Suri S, Gupta S, Suri R. Computed tomography in abdominal tuberculosis [Ｊ]. Br J Radiol， 1999; 72(853)∶92.
- 2. Vanhoenacker FM, De Backer AI, Op de BB， et al. Imaging of gastrointestinal and abdominal tuberculosis [Ｊ]. Eur Radiol, 2004; 14 Suppl 3∶E103.
- 3. Kim SH, Han JK, Lee KH， et al. Abdominal amyloidosis: spectrum of radiological findings [Ｊ]. Clin Radiol, 2003; 58(8)∶610.
- 4. Yang ZG, Min PQ, Sone S， et al. Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT [Ｊ]. AJR Am J Roentgenol, 1999; 172(3)∶619.
- 5. 郭俊渊主编. 现代腹部影像诊断学 [M]. 第1版. 北京: 科学出版社， 2001∶668~670.
- 6. 余日胜， 孙继红， 李蓉芬. 肝结核的CT与MRI表现 [Ｊ]. 中华放射学杂志, 2001; 35（5）∶367.
- 7. Yu RS, Zhang SZ, Wu JJ， et al. Imaging diagnosis of 12 patients with hepatic tuberculosis [Ｊ]. World J Gastroenterol, 2004; 10(11)∶1639.
- 8. 谢汝明， 周新华， 陈 冀, 等. 肝脾结核CT影像诊断 [Ｊ]. 中华结核和呼吸杂志， 1999; 22（4）∶237.
- 9. 吴恩惠主编. 医学影像学 [M]. 第5版. 北京: 人民卫生出版社， 2003∶115.
- 10. 张 建， 贾宏远， 段建国. 结核性肝脓肿1例 [Ｊ]. 中国医学影像学杂志， 2004; 12（6）∶477.
- 11. Akay MN, Polat KY, Oren D， et al. Primary tuberculous liver abscess. A case report and review of literature [Ｊ]. Int J Clin Pract, 2004; 58(6)∶625.
- 12. 彭旭红， 张雪林， 吴元魁, 等. 肝结核的CT诊断价值 [Ｊ]. 放射学实践， 2007; 22（5）∶478.
