摘要目的 探讨螺旋CT是否有助于脾结核的诊断.方法 收集40例经螺旋CT诊断的脾结核患者的临床资料,结合病理活检及临床诊疗结果综合分析螺旋CT诊断脾结核的准确率和临床影响因素以及CT影像学特征.结果 40例经螺旋CT检查诊断为脾结核的患者,结合穿刺活检病理及临床诊治结果,发现35例患者与活检病理及临床诊治得出的最终诊断较为一致,诊断的正确率为87.5％;螺旋CT的准确率与患者结核病史及病灶的类型明显相关(x2=15.873、23.804,均P＜0.01),而与患者的年龄、性别、病灶大小、贫血及红细胞沉降率无明显相关(x2=1.429、1.004、0.272、0.147、1.429,均P＞0.05);确诊的35例脾结核患者的CT表现可见多发性或弥漫性结节状病变,结核病灶大小约为5～45 mm,边界均不清楚,病变部位多呈低密度,增强后无明显强化,可见钙化灶.结论 螺旋CT有助于脾结核的诊断,具有重要的临床应用价值.

abstractsObjective To investigate whether spiral CT is helpful for the diagnosis of splenic tuberculosis.Methods During the recent six years in our hospital,forty splenic tuberculosis patients diagnosed by spiral CT were enrolled in this study.Combined with pathological biopsy and clinical diagnosis and treatment,the accuracy and clinical effect of spiral CT in diagnosis of splenic tuberculosis were comprehensively analyzed.Results 40 patients received CT test were diagnosed as splenic tuberculosis,and 35 patients with biopsy and clinical diagnosis was consistent with the final diagnosis,with the correct rate of diagnosis 87.5％;Type spiral CT accuracy rate and patients with history of tuberculosis and lesion had obvious correlation (x2 =15.873,23.804,all P ＜ 0.01),and patients'age,gender,tumor size,anemia and erythrocyte sedimentation rate had no significant correlation (x2 =1.429,1.004,0.272,0.147,1.429,all P ＞0.05);35 cases of splenic tuberculosis patients with CT diagnosed showed multiple or diffuse nodular lesions,and the lesion size was about tuberculosis 5 ～ 45 mm.The boundary was not clear,which was characterized by low density and had no obvious enhancement.Conclusion Spiral CT is beneficial for the diagnosis of splenic tuberculosis with important clinical value.