Abstract: Objective  To investigate the CT imaging features of tuberculous peritonitis and dynamic changes.  Methods  We retrospectively analyzed the CT imaging findings of 56 cases who confirmed by pathology, clinical and laboratory findings including ascites, peritoneal involvement (parietal peritoneum,omentum and mesentery), and lymphadenopathy. All of 56 patients underwent CT plain and enhanced scan collecting dynamic CT images during the treatment.  Results  Forty-five cases presented with ascites including 1 case with large, 44 cases with medium and small amount, 38 with encapsulated effusion, which CT values was greater than 20 HU in 34 cases. Parietal peritoneum was thickened in 46 cases including uniform thickness in 17 cases, flat mound-like bulge or peritoneal tuberculosis tumor in 29 cases with peripheral enhancement, liver capsule or liver involved in 15 cases. Omentum thickening was seen in 35 cases, including nodular thickening in 34 and omental cake in 1 which presented with mild heterogeneousness on enhanced scan. Mesenteric thickening was seen in 41 cases expressing  as nodules and linear, stellate-shaped high density, and intestinal loop adhesions. There were lymph node enlargement in 19 cases, calcification in 5 cases. The lymph nodes showed the appearance of a low attenuation center with ring contrast enhancement and honeycomb enhancement. Seventeen cases of complete dynamic CT images showed that peritoneal fluid absorption was fastest, followed by slower absorption of omentum and mesentery disease, peritoneal tuberculosis tumor shrunk slowest. Conclusion  The CT diagnosis of tuberculous peritonitis is a comprehensive variety of signs, a small amount of ascites with peritoneal, omental and mesenteric thickening and adhesion is the most common imaging findings. Dynamic CT images in clinical can evaluate the efficacy.

Key words: Peritonitis,tuberculous/radiography, Tomography, X-ray computed