Brizi M G, Celi G, Scaldazza A V, Barbaro B
Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy.
Rays. 1998 Jan-Mar;23(1):115-25.
Abdominal tuberculosis is usually associated to pulmonary tuberculosis. The most frequent gastrointestinal form is ulcerative illeocecal tuberculosis. Esophageal, gastric and duodenal locations are rare; jejunal and proximal ileal tuberculosis are rare during tuberculous peritonitis. The most common form with liver and spleen involvement is miliary tuberculosis, the macronodular form being rare. Tuberculous peritonitis is a common manifestation of abdominal tuberculosis with various aspects according to the presence of ascitis and the predominant fibrotic reaction. Most common abdominal manifestation is represented by lymph node involvement with four patterns recognized on CT. In AIDS patients together with Mycobacterium tuberculosis infection, there may be Mycobacterium avium complex infection with often indistinguishable imaging findings. Patterns are similar to those of immunocompetent patients, except for markedly immunocompromised subjects in whom disseminated forms are observed.
腹部结核通常与肺结核相关。最常见的胃肠道形式是溃疡性回盲部结核。食管、胃和十二指肠部位少见;结核性腹膜炎时空肠和回肠近端结核罕见。肝脾受累最常见的形式是粟粒性结核,大结节型罕见。结核性腹膜炎是腹部结核的常见表现,根据腹水的有无及主要纤维化反应有不同表现。最常见的腹部表现是淋巴结受累,CT上可识别出四种模式。在艾滋病患者中,除了结核分枝杆菌感染外,还可能有鸟分枝杆菌复合群感染,其影像学表现往往难以区分。这些模式与免疫功能正常的患者相似,但在明显免疫受损的患者中可见播散型表现。