肺肠泌尿结核2019实际用.ppt

小肠结核 增殖型肠结核（左，狭窄僵直、息肉样充盈缺损）， 溃疡型肠结核（右，跳跃征、小龛影和管腔狭窄）。 回肠结核（增殖型）：回肠末端粘膜皱襞紊乱消失，可见多数息肉样充盈缺损。盲肠受累，管腔收缩变形 小肠结核 小肠结核。增强CT示远侧几组小肠肠壁增厚（ △ ）。 RadioGraphics 2007; 27:1255–1273 泌尿生殖系结核（注1p）（Genitourinary Tuberculosis） 临床常见的肺外结核。经血行播散感染，如肾、前列腺、精囊；或直接延伸，如肾结核尿路播散引起输尿管、膀胱结核。 肾结核：75-90%单侧受累。检查方法首选静脉肾盂造影（intravenous pyelography, IVP），CT是常用方法，选用超声、MRU。病变始于肾髓质椎体深部和乳头部：结核性肉芽肿、干酪样坏死、空洞形成。IVP：早期肾盏虫噬样破坏，杯口样形态消失；进展期肾实质见空洞（对比剂充盈），肾盂肾盏不规则扩张、肾盏漏斗部狭窄；末期呈特征性段性分布的钙化（肾自切）。（注2） 输尿管结核：特征为管壁增厚、狭窄，最常累及远1/3段；狭窄好发于解剖学狭窄处：肾盂输尿管移行处、入盆处、输尿管膀胱移行处（最） ，继发肾盂、输尿管积水。 膀胱结核：容积减小，壁增厚、溃疡、充盈缺损，最终瘢痕化、形态不规则、钙化性小膀胱。 泌尿生殖系统-泌尿系统肿瘤 右侧肾盂癌，肾盂肾盏破坏(↑) Figure Renal tuberculosis. Intravenous urogram shows the characteristic appearance ofcaliceal erosions in the lower pole calices of the left kidney due to tuberculosis.肾盏虫噬样破坏，杯口样形态消失；进展期肾实质见空洞（对比剂充盈）。 RadioGraphics 2007; 27:1255–1273 女，48岁，左肾结核（注）肾盂肾盏不规则扩张、肾盏漏斗部狭窄。 Terminology Glossary mycobacterium tuberculosis, MTB primary pulmonary tuberculosis hemo-disseminated pulmonary tuberculosis post-primary pulmonary tuberculosis tuberculous pleuritis primary complex acute millary pulmonary tuberculosis reactivation infiltrative pulmonary tuberculosis chronic fibrous cavitary tuberculosis intestinal tuberculosis genitourinary tuberculosis intravenous pyelography, IVP That’s all for today. Tuberculosis (TB):A Radiologic Review （RadioGraphics 2007; 27:1255–1273 ） From the Department of Radiology, Central Middlesex Hospital, London, England (J.B., C.J.W., G.B., G.C., A.L.H.); and the Department of Radiology, Wycombe General Hospital, Queen Alexandra Rd, High Wycombe HP11 2TT, England (R.R.M.). 推荐阅读文献 Introduction The authors discuss and illustrate the clinical and radiologic features of TB involving the lungs, heart, central nervous system (CNS), head and neck, musculoskeletal system, and abdomen. In this article, the authors also review multidrug-resistant (MDR) tuberculosis, … and tuberculosis in immunocompromised patients. This article was presented as an education exhibit a