Mbengue Ababacar, Ndiaye Abdou Rahmane, Amar Ndeye Isseu, Diallo Moustapha, Diack Aminata, Ndao Mame Diarra, Diop Massamba, Fall Amath, Diouf Cheikh Tidiane, Soko Thierno Omar, Diakhate Ibrahima Cisse
Département d'Imagerie Médicale Hôpital Principal de Dakar , Dakar , Sénégal.
J Ultrason. 2019;19(77):98-104. doi: 10.15557/JoU.2019.0014. Epub 2019 Jun 28.
The objective of this work was to describe different presentations of peritoneal tuberculosis on ultrasound. This was a retrospective study conducted between 2008 and 2016 at the Main Hospital in Dakar, and including 38 cases of peritoneal tuberculosis. The tests were performed on Philips Envisor and Hitachi Preirus with 10 and 12 MHz linear transducers. The mean age was 26 years and the sex ratio was 0.8. The diagnosis of peritoneal tuberculosis was based on histological evidence (17 cases), isolation of BK from sputum (5 cases), positive adenosine deaminase in ascites fluid (4 cases) or a favorable clinical course after trial antituberculosis treatment (4 cases). The structures studied were the parietal peritoneum, the mesentery, the large omentum, as well as the characteristics of ascites, and extra-peritoneal lesions. Parietal peritoneal involvement was found in 89.4% of patients, including regular diffuse hypoechoic thickening in 70.5% and nodular thickening in 11.7%. Ascites was present in 84.2% of patients. The great omentum showed anomalies in 73.6% of cases in relation to 3 aspects: trilamellar thickening made up of a thick, hyperechoic central layer surrounded by 2 thin peripheral hypoechoic layers in 46.4% of cases; a single-layer hyperechoic thickening in 21.4% of cases; heterogeneous hyperechogenic thickening with hypoechoic nodules in 32.1% of cases. Mesentery abnormalities were noted in 63.1% of patients with hypoechoic thickening. Ultrasound with the advantage of safety and accessibility is a reliable technique for the diagnosis of peritoneal tuberculosis. In some cases, it allows for a guided percutaneous biopsy to avoid the use of laparoscopy. The objective of this work was to describe different presentations of peritoneal tuberculosis on ultrasound. This was a retrospective study conducted between 2008 and 2016 at the Main Hospital in Dakar, and including 38 cases of peritoneal tuberculosis. The tests were performed on Philips Envisor and Hitachi Preirus with 10 and 12 MHz linear transducers. The mean age was 26 years and the sex ratio was 0.8. The diagnosis of peritoneal tuberculosis was based on histological evidence (17 cases), isolation of BK from sputum (5 cases), positive adenosine deaminase in ascites fluid (4 cases) or a favorable clinical course after trial antituberculosis treatment (4 cases). The structures studied were the parietal peritoneum, the mesentery, the large omentum, as well as the characteristics of ascites, and extra-peritoneal lesions. Parietal peritoneal involvement was found in 89.4% of patients, including regular diffuse hypoechoic thickening in 70.5% and nodular thickening in 11.7%. Ascites was present in 84.2% of patients. The great omentum showed anomalies in 73.6% of cases in relation to 3 aspects: trilamellar thickening made up of a thick, hyperechoic central layer surrounded by 2 thin peripheral hypoechoic layers in 46.4% of cases; a single-layer hyperechoic thickening in 21.4% of cases; heterogeneous hyperechogenic thickening with hypoechoic nodules in 32.1% of cases. Mesentery abnormalities were noted in 63.1% of patients with hypoechoic thickening. Ultrasound with the advantage of safety and accessibility is a reliable technique for the diagnosis of peritoneal tuberculosis. In some cases, it allows for a guided percutaneous biopsy to avoid the use of laparoscopy.
这项工作的目的是描述超声检查中腹膜结核的不同表现。这是一项于2008年至2016年在达喀尔主医院进行的回顾性研究，纳入了38例腹膜结核病例。检查使用飞利浦Envisor和日立Preirus超声设备，配备10和12MHz的线性探头。平均年龄为26岁，男女比例为0.8。腹膜结核的诊断基于组织学证据（17例）、痰液中分离出BK（5例）、腹水腺苷脱氨酶阳性（4例）或试验性抗结核治疗后良好的临床病程（4例）。所研究的结构包括壁层腹膜、肠系膜、大网膜，以及腹水的特征和腹膜外病变。89.4%的患者存在壁层腹膜受累，其中70.5%为规则性弥漫性低回声增厚，11.7%为结节状增厚。84.2%的患者有腹水。73.6%的病例大网膜出现异常，涉及三个方面：46.4%的病例为三层增厚，由一层厚的高回声中央层和两层薄的外周低回声层组成；21.4%的病例为单层高回声增厚；32.1%的病例为不均匀高回声增厚伴低回声结节。63.1%的患者肠系膜有低回声增厚异常。超声具有安全、易操作的优点，是诊断腹膜结核的可靠技术。在某些情况下，它可用于引导经皮活检，从而避免使用腹腔镜检查。这项工作的目的是描述超声检查中腹膜结核的不同表现。这是一项于2008年至2016年在达喀尔主医院进行的回顾性研究，纳入了38例腹膜结核病例。检查使用飞利浦Envisor和日立Preirus超声设备配备10和12MHz的线性探头。平均年龄为26岁，男女比例为0.8。腹膜结核的诊断基于组织学证据（17例）、痰液中分离出BK（5例）、腹水腺苷脱氨酶阳性（）或试验性抗结核治疗后良好的临床病程（4例）。所研究的结构包括壁层腹膜、肠系膜、大网膜，以及腹水的特征和腹膜外病变。89.4%的患者存在壁层腹膜受累，其中70.5%为规则性弥漫性低回声增厚，11.7%为结节状增厚。84.2%的患者有腹水。73.6%的病例大网膜出现异常，涉及三个方面：46.4%的病例为三层增厚，由一层厚的高回声中央层和两层薄的外周低回声层组成；21.4%的病例为单层高回声增厚；32.1%的病例为不均匀高回声增厚伴低回声结节。63.1%的患者肠系膜有低回声增厚异常。超声具有安全、易操作的优点，是诊断腹膜结核的可靠技术。在某些情况下，它可用于引导经皮活检，从而避免使用腹腔镜检查。
