慢性血吸虫肝病及并发症的CT表现
CT Findings of Chronic Hepatic Schistosomiasis and Its Complications
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摘要: 目的 分析慢性血吸虫肝病的CT特征,以提高CT对该病诊断的准确性.方法 分析125例临床病理确诊的慢性血吸虫肝病和50例正常对照组的CT特征,并对其各肝叶径线及脾指数进行测量对比.结果(1)血吸虫性钙化:125例中,120例肝脏有不同程度的钙化:肝内及肝包膜下线条样钙化76例,肝内地图样和网格样钙化44例,肝内门脉系统钙化33例;脾脏钙化15例,肠壁钙化85例;(2)肝脾形态改变:肝尾状叶、肝左叶增大,且肝尾状/肝右叶比值亦较正常组大,肝右叶缩小,差异有统计学意义(P<0.01),胆囊窝增大82例,脾指数与正常组无统计学差异(P>0.05);(3)血吸虫肝病合并症:胆囊炎和胆囊结石58例,肝癌11例,肠癌5例,膀胱癌3例.结论 肝内钙化和肝左叶及尾叶增大为慢性血吸虫肝病CT征象,常合并许多并发症.Abstract: Objective To analyze the CT characteristics of chronic schistosomiasis liver disease,in order to improve the accuracy of CT diagnosis for the disease.Methods We analyzed the CT features of 125 cases of clinical pathology diagnosis of chronic schistosomiasis liver and of 50 normal control group,and measured the hepatic lobe lines and spleen index.Results(1) Schistosoma calcification:In 125 cases,there were 120 patients with varying degrees of liver calcification, in which 76 cases of intrahepatic or subcapsularlinear calcification,44 cases of reticular or map-like calcification,33 cases of calcification portal system,15 cases of spleen calcification,85 cases of intestinal wall calcification;(2) Morphological changes of the liver and spleen:The transverse diameter of the left hepatic lobe,caudate lobe,and caudate lobe-right lobe ratio were larger in patients with chronic schistosomiasis than controls,the transverse diameter of the right hepatic lobe were smaller and there were statistically difference(P<0.001).There were 82 cases of expanded gallbladder fossa in chronic schistosomiasis.Splenic index in patients with chronic schistosomiasis and had no obvious difference in the control group(P>0.05);(3) Schistosomiasis liver's complications:there were 43 cases of cholecystitis and cholelithiasis,11 cases of liver cancer,5 cases of colon cancer,3 cases of bladder cancer.Conclusion Intrahepatic calcification and the left hepatic lobe and caudate lobe enlargement are CT signs of chronic schistosomiasis,which is often merged with many complications.
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Key words:
- Schistosomiasis /
- Liverdisease /
- Complication /
- Computed tomography
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[1] [1]COLLEY D G,AMAYA L BUSTINDUY,SECOR W E,et al.Human schistosomiasis[J].Lancet,2014,383(9936):2253-2264. [2] [2]HARBIN W P,ROBERT H J,FERRUCCI J T F J.Diagnosis of cirrhosis based on regional changes in hepatic morphology:a radiological and pathological analysis[J].Radiology,1980,135(2):273-283. [3]林昭旺.肝脏弥漫性疾患CT数量化测量的临床研究[J].中国医药导报,2008,5(6):86. [4]杨伟力,李军宅.肋单元法与脾指数法评估脾脏大小的比较[J].中国当代医药,2014,21(2):129-131. [5]李石柱,郑浩,高婧,等.2012年全国血吸虫病疫情通报[J].中国血吸虫病防治杂志,2013,25(6):557-563. [6]赵建玲,屈明,张凡,等.中药制剂对血吸虫性肝纤维化病理及超微结构的影响[J].河北北方学院学报(医学版),2008,23(2):50-51. [7]张洪,孟令平.血吸虫肝病磁共振成像进展[J].国际医学放射学杂志,2015,38(5):438-441. [8]潘伟,李香营.慢性肝血吸虫病的CT诊断价值[J].中国热带医学,2013,13(8):1002-1004. [9]郝卫刚,王小明,易文全,等.498例血吸虫病患者病变部位分析[J].中国血吸虫病防治杂志,2013,24(4):428-432. [10] [10]SILVA L C,ANDRADE L M,DE PAULA I B,et al.Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni:Expanded gallbladder fossa and fatty hilum signs[J].Rev Soc Bras Med Trop,2012,45(4):500-504. [11] [11]BEZERRA A S,D'IPPOLITO G,CALDANA R P,et al.Differentiating cirrhosis and chronic hepatosplenic schistosomiasis using MRI[J].AJR Am J Roentgenol,2008,190(3):201-207. [12]张有益,罗新,冯军,等.慢性血吸虫肝病的CT表现(附108例报告)[J].实用放射学杂志,2006,22(4):505-506. [13]张雪瑞,翟建.血吸虫病肝脏的影像学表现[J].医学综述,2009,15(7):1094-1096. [14]刘铁,宋敏芳,董吉顺,等.慢性血吸虫病腹部CT及病理对照研究[J].中华放射学杂志,2005,39(11):1188-1191. [15]吴亮,田德英.晚期血吸虫病的中西医结合诊疗[J].临床肝胆病杂志,2015,31(1):52-57. [16]曾冬明.慢性肝血吸虫病的CT诊断价值分析[J].医学临床研究,2007,24(5):789-791. [17]杨文广,汪海滔,牛雪花,等.晚期血吸虫肝硬化并发肝癌的临床及CT影像特征[J].临床荟萃,2013,28(8):923-926. [18]沈星,张炜,王培军.慢性血吸虫病腹部CT表现与病理基础[J].中国血吸虫病防治杂志,2012,24(2):200-202. [19] [19]MANZELLA A,OHTOMO K,MONZAWA S,et al.Schistosomiasis of the liver[J].Abdominal Imaging,2008,33(2):144-150. -
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