What are the findings of abdominal tuberculosis on CT and MRI?
Circumferential mural thickening of the cecum and terminal ileum are usually seen. Occasionally, there is asymmetric thickening of the medial wall of the cecum and ileocecal valve that extends into the adjacent tissues with resultant engulfment of the terminal ileum; a presentation that may mimic that of lymphoma. Abdominal lymphadenopathy, which is the most common manifestation of abdominal tuberculosis, is present in up to two thirds of patients. Typically, the abnormal lymph nodes demonstrate central hypoattenuation, central high T2-weighted signal intensity (relative to skeletal muscle), and central nonenhancement related to central necrosis, along with peripheral hyperenhancement related to granulation tissue, inflammation, and hypervascularity. Despite their bulky appearance, these nodes seldom cause obstruction of the adjacent bowel or ureters. Peritoneal spread of infection may be encountered, as manifested by exudative ascites, peritoneal thickening, peritoneal enhancement, and omental/mesenteric soft tissue infiltration or caking. Nonspecific appearing lesions in abdominal solid organs may also be encountered.
