囊型肝包虫病的多排螺旋CT表现与分型
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摘要
目的探讨多排螺旋计算机X线断层扫描(computed tomography,CT)对囊型肝包虫病诊断价值与分型。方法回顾性分析武警总医院2016-02至2017-02经手术病理证实的囊型肝包虫68例患者的临床及CT影像资料,总结其多排螺旋CT表现与分型。结果手术病理证实68例肝包虫病例共计肝内病灶112个,其中84个病灶位于肝右叶,28个病灶位于肝左叶。单囊型囊肿27例,表现为囊液均匀呈液体密度,增强扫描后囊壁轻度强化;多子囊型囊肿15例,表现为多个子囊沿母囊内壁排列成"蜂房状",子囊内密度低于母囊;内囊塌陷型囊肿12例,表现为内囊从外囊剥离,形成"飘带征";实变型囊肿2例,表现为内囊破裂、囊液浓缩,病灶类似实质性肿瘤;钙化型囊肿12例,表现为边缘全部钙化后,形成典型"蛋壳样"改变。结论多排螺旋CT可较好地显示囊型肝包虫病的影像特征,为临床诊断提供更多有价值的信息。
Objective The objective of this study was to investigate the diagnostic value of multi-detector helical computed tomography(CT)in the detection of hepatic cystic echinococcosis,and its type.Methods A total of 68 patients with hepatic cystic echinococcosis in the General Hospital of Chinese People's Armed Police Force between February 2016 and February 2017 were collected in this study,and the data were retrospectively analyzed.Results A total of 112 liver lesions manifesting in 68 patients with hepatic cystic echinococcosis,of which 84 lesions were located in the right lobe of the liver and 28 lesions in the left lobe of the liver.The unilocular cysts which occurred in 27 cases were characterized by a uniform liquid density of the cystic fluid and a slight enhancement in the wall of the capsule after enhanced scan.The multiple cysts which occurred in 15 cases were found to form a"honeycomb"along the inner wall of the mother capsule,and the inner density of the cysts was lower than that of the mother cyst.The collapsed cysts which occurred in 12 cases appeared like ribbons,with the inner cyst wall peeling from its outer layers.Two cases of consolidation lesions were accompanied with ruptured inner cyst and cyst fluid concentration,looking like substantial tumor.12 cases of calcified cysts manifested the typical"eggshell"shape following the calcification of the edges.Conclusions Multi-detector helical CT examination can display image features of cystic hydatid disease and provide valuable information for its clinical diagnosis.
Objective The objective of this study was to investigate the diagnostic value of multi-detector helical computed tomography(CT)in the detection of hepatic cystic echinococcosis,and its type.Methods A total of 68 patients with hepatic cystic echinococcosis in the General Hospital of Chinese People's Armed Police Force between February 2016 and February 2017 were collected in this study,and the data were retrospectively analyzed.Results A total of 112 liver lesions manifesting in 68 patients with hepatic cystic echinococcosis,of which 84 lesions were located in the right lobe of the liver and 28 lesions in the left lobe of the liver.The unilocular cysts which occurred in 27 cases were characterized by a uniform liquid density of the cystic fluid and a slight enhancement in the wall of the capsule after enhanced scan.The multiple cysts which occurred in 15 cases were found to form a"honeycomb"along the inner wall of the mother capsule,and the inner density of the cysts was lower than that of the mother cyst.The collapsed cysts which occurred in 12 cases appeared like ribbons,with the inner cyst wall peeling from its outer layers.Two cases of consolidation lesions were accompanied with ruptured inner cyst and cyst fluid concentration,looking like substantial tumor.12 cases of calcified cysts manifested the typical"eggshell"shape following the calcification of the edges.Conclusions Multi-detector helical CT examination can display image features of cystic hydatid disease and provide valuable information for its clinical diagnosis.
引文
[1]彭赟杰,邵英梅.肝囊型包虫病破入胆道的诊疗现状[J].中国普通外科杂志,2009,18(8):861-863.DOI:1005-6947(2009)08-0861-03.
[2]Zhang W,Zhang Z,Wu W,et al.Epidemiology and control of echinococcosis in central Asia,with particular reference to the People's Republic of China[J].Acta Trop,2015,141(pt B):235-243.DOI:10.1016/j.actatropica.2014.03.014.
[3]中国医师协会外科医师分会包虫病外科专业委员会.肝两型包虫病诊断与治疗专家共识(2015版)[J].中华消化外科杂志,2015,4(14):253-264.DOI:10.3760/cma.j.issn.1673-9752.2015.04.001.
[4]温浩,栾梅香,杨文光,等.肝包虫病的标准化分型及临床意义探讨[J].新疆医科大学学报,2002,25(2):129-130.DOI:10.3969/j.issn.1009-5551.2002.02.005.
[5]Rinaldi F,Brunetti E,Neumayr A,et al.Cystic echinococcosis of the liver:A primer for hepatologists[J].World J Hepatol,2014,6(5):293-305.DOI:10.4254/wjh.v6.i5.293.
[6]Alghofaily K A,Saeedan M B,Aljohani I M,et al.Hepatic hydatid disease complications:review of imaging findings and clinical implications[J].Abdom Radiol(NY),2017,42(1):199-210.DOI:10.1007/s00261-016-0860-2.
[7]仁真,李调英,廖万明,等.包虫病手术患者1312例流行病学资料分析[J].寄生虫病与感染性疾病,2008,6(3):117-120.DOI:10.3969/j.issn.1672-2116.2008.03.001.
[8]朱明生,桂东川,赵峰,等.91例肝包虫囊肿退行性变的CT诊断分析[J].中国人兽共患病学报,2009,25(2):200-201.DOI:10.3969/j.issn.1002-2694.2009.02.028.
[9]吴向未,彭心宇,张示杰,等.肝脾棘球蚴囊周围纤维性囊壁形成机制的差异及临床意义[J].中国寄生虫学与寄生虫病杂志,2004,22(1):1-4.DOI:10.3969/j.issn.1000-7423.2004.01.001.
[10]谢天皓,吕海龙,车小双,等.肝包虫囊肿退行性变的CT诊断[J].实用放射学杂志,2013,29(7):1098-1101.DOI:10.3969/j.issn.1002-1671.2013.07.018.
[11]赵阳阳,张示杰,车小双,等.肝囊性包虫病的CT表现与临床病理改变的相关性研究[J].实用医学杂志,2013,29(13):2107-2110.DOI:10.3969/j.issn.1006-5725.2013.13.014.
[12]Hosch W,Stojkovic M,J?nisch T,et al.The role of calcification for staging cystic echinococcosis(CE)[J].Eur Radiol,2007,17(10):2538-2545.DOI:10.1007/s00330-007-0638-6.
[13]吐尔干艾力,邵英梅,赵晋明,等.肝囊型包虫病胆道并发症284例的诊治分析[J].中华肝胆外科杂志,2011,17(2):104-109.DOI:10.3760/cma.j.issn.1007-8118.2007.06.008.
[14]姚昆琛,陶建华,边雪峰,等.MSCT对肝包虫囊肿及并发症的诊断价值[J].中国中西医结合影像学杂,2013,11(4):363-365.DOI:10.3969/j.issn.1672-0512.2013.04.007.
[15]李明皓,张多强,杨志琪.肝包虫病合并胆管梗阻的诊断和治疗[J].中国普外基础与临床杂志,2015,22(2):131-133.DOI:10.7507/1007-9424.20150036.
[2]Zhang W,Zhang Z,Wu W,et al.Epidemiology and control of echinococcosis in central Asia,with particular reference to the People's Republic of China[J].Acta Trop,2015,141(pt B):235-243.DOI:10.1016/j.actatropica.2014.03.014.
[3]中国医师协会外科医师分会包虫病外科专业委员会.肝两型包虫病诊断与治疗专家共识(2015版)[J].中华消化外科杂志,2015,4(14):253-264.DOI:10.3760/cma.j.issn.1673-9752.2015.04.001.
[4]温浩,栾梅香,杨文光,等.肝包虫病的标准化分型及临床意义探讨[J].新疆医科大学学报,2002,25(2):129-130.DOI:10.3969/j.issn.1009-5551.2002.02.005.
[5]Rinaldi F,Brunetti E,Neumayr A,et al.Cystic echinococcosis of the liver:A primer for hepatologists[J].World J Hepatol,2014,6(5):293-305.DOI:10.4254/wjh.v6.i5.293.
[6]Alghofaily K A,Saeedan M B,Aljohani I M,et al.Hepatic hydatid disease complications:review of imaging findings and clinical implications[J].Abdom Radiol(NY),2017,42(1):199-210.DOI:10.1007/s00261-016-0860-2.
[7]仁真,李调英,廖万明,等.包虫病手术患者1312例流行病学资料分析[J].寄生虫病与感染性疾病,2008,6(3):117-120.DOI:10.3969/j.issn.1672-2116.2008.03.001.
[8]朱明生,桂东川,赵峰,等.91例肝包虫囊肿退行性变的CT诊断分析[J].中国人兽共患病学报,2009,25(2):200-201.DOI:10.3969/j.issn.1002-2694.2009.02.028.
[9]吴向未,彭心宇,张示杰,等.肝脾棘球蚴囊周围纤维性囊壁形成机制的差异及临床意义[J].中国寄生虫学与寄生虫病杂志,2004,22(1):1-4.DOI:10.3969/j.issn.1000-7423.2004.01.001.
[10]谢天皓,吕海龙,车小双,等.肝包虫囊肿退行性变的CT诊断[J].实用放射学杂志,2013,29(7):1098-1101.DOI:10.3969/j.issn.1002-1671.2013.07.018.
[11]赵阳阳,张示杰,车小双,等.肝囊性包虫病的CT表现与临床病理改变的相关性研究[J].实用医学杂志,2013,29(13):2107-2110.DOI:10.3969/j.issn.1006-5725.2013.13.014.
[12]Hosch W,Stojkovic M,J?nisch T,et al.The role of calcification for staging cystic echinococcosis(CE)[J].Eur Radiol,2007,17(10):2538-2545.DOI:10.1007/s00330-007-0638-6.
[13]吐尔干艾力,邵英梅,赵晋明,等.肝囊型包虫病胆道并发症284例的诊治分析[J].中华肝胆外科杂志,2011,17(2):104-109.DOI:10.3760/cma.j.issn.1007-8118.2007.06.008.
[14]姚昆琛,陶建华,边雪峰,等.MSCT对肝包虫囊肿及并发症的诊断价值[J].中国中西医结合影像学杂,2013,11(4):363-365.DOI:10.3969/j.issn.1672-0512.2013.04.007.
[15]李明皓,张多强,杨志琪.肝包虫病合并胆管梗阻的诊断和治疗[J].中国普外基础与临床杂志,2015,22(2):131-133.DOI:10.7507/1007-9424.20150036.