关键词: 腹膜疾病, 腹膜炎, 结核性, 腹膜肿瘤, 体层摄影术, X线计算机, 诊断, 鉴别

Abstract:

Objective To analyze CT imaging characteristics of three common diffuse peritoneal lesions,and to explore the value of CT in the diagnosis and differential diagnosis of diffuse peritoneal lesions. Methods We retrospectively analyzed characteristics of CT imaging in 72 cases with diffuse peritoneal lesions, including 16 cases with tuberculous peritonitis (TBP), 34 cases with peritoneal metastasis (PM),22 cases with peritoneal mesothelioma (PMM). Results (1) The incidence rates of uniform peritoneal thickening were 62.5% (10/16) in TBP, 23.5% (8/34) in PM, 27.3% (6/22) in PMM, the differences between TBP and PM, TBP and PPM were statistically significant (χ ²=5.221,P=0.022; χ ²=10.795,P=0.010); the incidence rates of omentum majus dirt-like thickening were 43.8% (7/16) in TBP, 2.9% (1/34) in PM, 13.6% (3/22) in PMM, the differences between TBP and PM, TBP and PPM were statistically significant (χ ²=14.567,P=0.000; χ ²=4.332,P=0.037); the incidence rates of “omentum cake sign” were 6.2% (1/16) in TBP, 50.0% (17/34) in PM, 27.3% (6/22) in PMM, there was statistically significant difference between TBP and PM (χ ²=9.039,P=0.003), but difference was not statistically significant between TBP and PMM (χ ²=1.216,P=0.270); the incidence rates of nodules or mass thickening of greater omentum were 12.5% (2/16) in TBP, 14.7% (5/34) in PM, 50.0% (11/22) in PMM, the differences were statistically significant between TBP and PMM,PM and PMM (χ ²=5.788,P=0.016;χ ²=8.153,P=0.004). (2) The incidence rates of medium and small amount of ascitic fluid were 75.0% (12/16) in TBP, 32.4% (11/34) in PM, 40.9% (9/22) in PMM, there were statistically significant differences between TBP and PM,TBP and PMM (χ ²=7.966,P=0.005;χ ²=4.354,P=0.037); the incidence rates of large amount of ascitic fluid were 25.0% (4/16) in TBP, 67.6% (23/34) in PM, 59.1% (13/22) in PMM,there were statistically significant differences between TBP and PM,TBP and PMM (χ ²=7.966, P=0.005; χ ²=4.354, P=0.037). (3) The incidence rates of cardiac phrenic angle lymphadenopathy were 6.2% (1/16) in TBP, 5.9% (2/34) in PM, 40.9% (9/22) in PMM, the incidence differences between PMM and TBP, PMM and PM were statistically significant (χ ²=5.739,P=0.017;χ ²=10.382,P=0.001). Conclusion The specific visual characteristics on CT imaging, such as the location of peritoneal lesions, morphology, ascitic fluid and lymph nodes are of great value in the differential diagnosis of peritoneal diffused lesions.

Key words: Peritoneal diseases, Peritonitis, tuberculous, Peritoneal neoplasms, Tomography, X-ray computed, Diagnosis, differential