Lee I J, Ha H K, Park C M, Kim J K, Kim J H, Kim T K, Kim J C, Cho K S, Auh Y H
Department of Radiology, University of Ulsan, Asan Medical Center, 388-1 Poongnap-dong, Songpa-ku, Seoul, 138-736, Korea.
Radiology. 2001 Jul;220(1):76-80. doi: 10.1148/radiology.220.1.r01jl1376.
To assess the computed tomographic (CT) features of abdominopelvic actinomycosis involving the gastrointestinal tract.
CT scans were analyzed in 18 patients with pathologically proved abdominopelvic actinomycosis involving the gastrointestinal tract. Eight patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness, length, bowel involvement patterns, inflammatory infiltration, and features of peritoneal or pelvic mass, if present, were evaluated at CT.
Of the gastrointestinal tract, the sigmoid colon was most commonly involved (50%). All patients showed concentric (n = 15) or eccentric (n = 3) bowel wall thickening, with a mean thickness of 1.2 cm and a mean length of 8.3 cm. The thickened bowel enhanced homogeneously in nine patients and heterogeneously in the other nine. Inflammatory infiltration was mostly diffuse and severe. In 17 patients, a peritoneal or pelvic mass (mean maximum diameter, 3.2 cm) was seen adjacent to the involved bowel and appeared to be heterogeneously enhanced in most cases; infiltration into the abdominal wall was seen in four patients.
Actinomycosis should be included in the differential diagnosis when CT scans show bowel wall thickening and regional pelvic or peritoneal mass with extensive infiltration, especially in patients with abdominal pain, fever, leukocytosis, or long-term use of intrauterine contraceptive devices.
评估累及胃肠道的腹盆腔放线菌病的计算机断层扫描（CT）特征。
对18例经病理证实累及胃肠道的腹盆腔放线菌病患者的CT扫描进行分析。8例患者有使用宫内节育器的病史。在CT上评估肠道部位、肠壁厚度、长度、肠道受累模式、炎症浸润以及腹膜或盆腔肿块的特征（如有）。
在胃肠道中，乙状结肠最常受累（50%）。所有患者均表现为同心性（n = 15）或偏心性（n = 3）肠壁增厚，平均厚度为1.2 cm，平均长度为8.3 cm。9例患者增厚的肠壁呈均匀强化，另外9例呈不均匀强化。炎症浸润大多为弥漫性且严重。17例患者在受累肠管附近可见腹膜或盆腔肿块（平均最大直径3.2 cm），大多数情况下表现为不均匀强化；4例患者可见腹壁浸润。
当CT扫描显示肠壁增厚、伴有广泛浸润的局部盆腔或腹膜肿块时，尤其是伴有腹痛、发热、白细胞增多或长期使用宫内节育器的患者，应将放线菌病纳入鉴别诊断。
