Imaging Analysis of Extrapulmonary Tuberculosis:Female Pelvic Tuberculosis, Parotid Tuberculosis, Hepatic Tuberculosis

作     者：DR.SHAMBHU KUMAR SAH 

作者单位：重庆医科大学 

学位级别：硕士

导师姓名：李咏梅

授予年度：2016年

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主      题：Pelvic tuberculosis computed tomography pelvic mass ascites CA125 Parotid gland tuberculosis lymph node CT pathology Hepatic tuberculosis CT chest pathology 

摘      要：Purpose: To analyze the computed tomography(CT) findings and the reasons for misdiagnosis of female pelvic ***: The clinical and CT features of 32 cases of female pelvic tuberculosis identified over a five-year period(2010-2015) were retrospectively analyzed. The CT features were analyzed for nature, range and extent of the various pathological ***: Because of the non-specific clinical and CT features, 20 of 32 cases were misdiagnosed either as ovarian tumor, or chocolate cyst, or PID preoperatively and received surgery. The mean age of the patients was 29.97 years(age range 15-67 years). Elevated levels of serum CA125 were found in 29 patients(90.62%, 29/32). The CT findings were as follows: 1. Pelvic mass(87.5%, 28/32): unilateral adnexal mass was in 15 cases, bilateral in 13 cases, 8 masses were cystic, 10 were solid, 23 were mixed, 24 masses showed multilocular caseous necrotic enhancement;2. Ascites(40.62%, 13/32): 8 of 13 cases showed high density ascites(CT value 18 HU);3. Thickening and enhancement of peritoneum(37.5%, 12/32): nodulously thickened in 7 cases, smoothly in 5 cases;4. Adhesion in the abdominopelvic cavity(28.12%, 9/32);5. Lymphadenopathy(21.87%, 7/32): calcified in 4 cases, low attenuation necrotic lymph nodes with ring enhancement in 2 cases;6. Thickening and enhancement of bowel wall(15.62%, 5/32).Conclusions: Integrated with clinical history and laboratory tests, pelvic tuberculosis should be considered in young female patients with elevated CA125 and CT findings ofadnexal mixed(solid and cystic) mass with multilocular caseous necrotic enhancement, high density ascites, thickened and enhanced peritoneum. Early diagnosis of the disease is a key consideration for early institution of anti-TB therapy to avoid misdiagnosis and surgical ***: To analyze the CT features and the reasons for misdiagnosis of parotid tuberculosis(TB).Methods: CT features of 13 cases of parotid TB identified over a ten-yea