艾滋病合并腹部结核的CT表现

目的 研究艾滋病(AIDS)合并腹部结核的CT表现.方法 回顾性分析33例经病理、病原学证实及临床诊断艾滋病合并腹部结核的腹部CT扫描表现.结果 33例AIDS合并腹部结核患者腹部CT示腹部淋巴结肿大23例(69.7%,23/33);肝脾肿大10例(30.3%,10/33);脾内多发低密度结节14例(42.4%,14/33),其中脾内弥漫粟粒状低密度结节9例(27.3%,9/33);肝内低密度结节7例(21. 2%,7/33),其中肝脓肿1例(3.0%,1/33);腹膜及大网膜增厚5例(15.2%,5/33),其中伴腹腔积液2例(6.1%,2/33);回盲部肠壁不规则增厚4例(12.1%,4/33);腰椎骨质破坏伴椎旁脓肿及左腰大肌脓肿1例(3.0%,1/33),腰大肌脓肿1例(3.0%,1/33).结论 AIDS合并腹部结核常表现肝脾结核、腹部淋巴结结核、肠结核及腹膜结核等,CT对病灶的检出有重要意义.

CT findings of abdominal tuberculosis in patients with acquired immunodeficiency syndrome

Objective To study the CT findings of abdominal tuberculosis in patients with AIDS.Methods CT imaging features of abdominal tuberculosis in 33 patients with AIDS were retrospectively analyzed. Results Abdominal lymph adenopathy were observed in 23 cases (69. 7%, 23/33 ).Hepatosplenomegaly were observed in 10 cases (30. 3%, 10/33). Multiple low density nodes in spleen were observed in 14 cases(42. 4%, 14/33)including 9 cases of diffuse, low density nodes (27. 3% ,9/33). Low density lesions in liver were observed in 7 cases (21.2%, 7/33 ) including a case of tuberculous abscess (3.0%, 1/33 ) . Peritoneum and epiploon involvements were found in 5 cases ( 15.2%, 5/33 ) with associated ascites in 2 cases ( 6. 1%, 2/33 ) . Thickening of intestines wall were observed in 4 cases ( 12. 1% ,4/33). Destruction of lumbar vertebra with cold abscess was observed in 1 case (3.0% ,1/33).Abscess in psoas was observed in 1 case (3.0%, 1/33). Conclusion Abdominal tuberculosis in patients with AIDS usually involves multiple organs in the abdomen. CT has an important role in the detection and following up examination of these lesions.