Đặc điểm hình ảnh lao ống tiêu hóa dưới cơ hoành trên cắt lớp vi tính

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Tác giả: Văn Hải Dương, Bảo Ngọc Huỳnh, Đại Hùng Linh Nguyễn, Vĩnh Tâm Trương

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.166

Bộ sưu tập: Metadata

ID: 339402

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- Mục tiêu: Mô tả đặc điểm hình ảnh tổn thương tại thành ruột và ngoài thành ruột ở bệnh nhân lao ống tiêu hóa dưới cơ hoành trên cắt lớp vi tính.- Phương pháp nghiên cứu: Thiết kế nghiên cứu cắt ngang mô tả, hồi cứu. Từ 01/01/2018 đến 30/03/2022, hồi cứu 44 trường hợp lao ống tiêu hóa có bằng chứng giải phẫu bệnh được điều trị bằng phương pháp phẫu thuật tại bệnh viện Bình Dân.- Kết quả: Tuổi mắc bệnh trung bình là 48. Nam có tần suất mắc cao hơn nữ (10:1). Triệu chứng lâm sàng thường gặp là đau bụng, rối loạn tiêu hóa, chán ăn sụt cân. Bệnh nhân lao ruột có kèm theo lao phổi chiếm 68,18%. Đối với tổn thương tại thành ruột, vị trí thường gặp nhất là vùng hồi manh tràng 90,91%, kiểu hình tổn thương đa dạng bao gồm tạo khối u lao (33/44 trường hợp) và không tạo khối (44/44 trường hợp). U lao thường ngấm thuốc tương phản đồng nhất, thâm nhiễm mỡ xung quanh. Ngược lại, thành ruột có tổn thương nhiều đoạn theo kiểu bước nhảy, độ dài tổn thương khu trú (<
5cm) chiếm đa số, độ dày mức độ trung bình chiếm 68,92%. Đối với tổn thương ngoài thành ruột. Tổn thương lá phúc mạc và mạc nối gặp trong 63,64% trường hợp. 50% trường hợp có dịch ổ bụng, dịch lượng ít chiếm đa số 86,36%, đậm độ HU trung bình 14,45 ± 3,66. Hạch ổ bụng gặp trong tất cả các trường hợp, phân bố chủ yếu trong mạc treo vùng hồi manh tràng, kiểu hình ngấm thuốc đồng nhất chiếm 84,09%. - Kết luận: Lao ruột có biểu hiện hình ảnh tổn thương tại thành ruột và ngoài thành ruột đa dạng trên CLVT. Kết hợp đặc điểm hình ảnh tổn thương thành ruột khu trú, nhiều vị trí theo kiểu bước nhảy, đặc biệt có ảnh hưởng đến vùng hồi manh tràng, với thông tin lâm sàng và hình ảnh xquang phổi là yếu tố hướng đến chẩn đoán lao ruột. Abstract- Objectives: To evaluateradiological features of gastrointestinal tract tuberculosis on computed tomography.- Methods: Cross - sectional and intramural and extramuralretrospective study. The computed tomography examinations from 44 patients, who had been operated on at Binh Dan hospital and had pathology reportbetween January 2018 and March2022, were reviewed.- Results: The average age of patient was 48. There is a male predilection (M:F 10:1). Almost all cases experienced symptoms including abdonimal pain, digestive disorders, loss of apetit and weight and 68,18% of them had pulmonary tuberculosis.The most common site of intestinal tuberculosis was the ileocecal region (90.91%), the lesion featureswerevaried, including mass forming (33/44 cases) and non - mass - forming (44/44 cases). Mass - forming lesions showed homogenous enhancement and infiltrated surrounding fat. In non - mass - forming ones, most of the patients had skip lesions, the majority of the involved segmentswere focal (<
5cm), the moderate bowel wall thickening accounted for 68.92 %.63,64% of cases showed peritoneal and omentalinvolvements, 50% hadascites, the average HU was 14,45 ± 3,66 and 86,36% of them were small amounts. Abdominal lymph nodes were found in all cases, distributed mainly in ileocecal mesentery, 84.09% of them showed the homogenous enhancement. - Conclusions: Intramural and extramuralradiological features of gastrointestinal tract tuberculosis on computed tomography arevaried. Combining radiological features of focal intestinal wall lesions, skip lesion patterns, especially affecting the ileocecal region, with clinical information and chest x-ray images are factors leading to the diagnosis of gastrointestinal tract tuberculosis. DOI: 10.59715/pntjmp.1.4.19

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