Objective To explore the value of CT in the diagnosis of tuberculous peritonitis and carcinoma-tous peritonitis. Methods Forty-seven patients with massive ascites admitted in our hospital from August 2008 to December 2009 were examined with 64-slice spiral CT. The following aspects were observed: ① the form, distribution and enhanced features of peritoneal wall thickening; ② the distribution of ascites; ③ the change of omentum; ④ the change of mesentery; ⑤ the change of abdominal lymph nodes. Results Five patients showed encapsulated effusion, 16 showed parietal peritoneum. Eight patients showed high-density effusion under liver membrane, and 4 showed pericardial calcification. Seven patients showed intra-abdominal and retroperitoneal lymph nodes combined central calcified lesions. Conclusion CT findings combined with clinical findings and laboratory tests can be used to identify the ascites.%目的 探讨CT诊断良恶性腹腔积液的价值.方法 收集2008年8月至2009年12月临床以大量腹水待查收住的患者47例,使用GE 64排螺旋CT,CT观察内容包括:①壁腹膜增厚的形式、分布范围及强化特征；②腹水分布形式；③大网膜改变；④肠系膜改变；⑤腹腔淋巴结改变.结果 结核性腹膜炎中有5例表现为包裹性积液,16例表现为壁层腹膜显著现状均匀强化；8例表现为肝脏背膜下高密度积液；4例表现心包膜的弧线状钙化；7例表现为腹腔及腹膜后肿大淋巴结合并病灶中央钙化；结论 CT表现结合临床以及实验室检查可以作为鉴别诊断腹水性质的有效手段.
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