实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (4): 585-588.doi: 10.3969/j.issn.1672-5069.2019.04.034

• 肝包虫病 • 上一篇    下一篇

泡型肝包虫病多脏器侵犯MRI表现*

李林昌   

  1. 810000 西宁市 青海大学附属医院放射科
  • 收稿日期:2018-07-12 出版日期:2019-07-10 发布日期:2019-07-19
  • 作者简介:李林昌,男,37岁,大学本科,主治医师。E-mail:51167131@qq.com
  • 基金资助:
    *青海省自然科学基金资助项目(编号:826328)

Feature of magnetic resonance imaging in patients alveolar hepatic echinococcosis and complicated multiple organ invasion

Li Linchang   

  1. Department of Radiology,Affiliated Hospital, inghai University,Xining 810000,Qinghai Province,China
  • Received:2018-07-12 Online:2019-07-10 Published:2019-07-19

摘要: 目的 分析总结泡型肝包虫病患者多脏器侵犯磁共振成像(MRI)表现特征。方法 2016年2月~2018年1月我院收治的泡型肝包虫病患者210例,均经手术组织病理学检查诊断,回顾性分析其MRI表现。结果 在本组210例泡型肝包虫病患者中,病灶位于左叶者55例(26.2%),位于右叶者120例(57.1%),左右叶均受累者35例(16.7%)。腹部MRI表现在STIR序列上观察到囊性病灶,大囊内有数个大小不一的子囊,肝内大块状异常信号,基质MRI信号呈长T1长T2,T1W1呈低信号,T2WI呈高信号;并发脑侵犯者27例(12.9%),双肺侵犯者36例(17.1%),脑和双肺侵犯者42例(20.0%),脑和肾侵犯者29例(13.8%),脑、肺、肾等多脏器侵犯者21例(10.0%)。脑侵犯者MRI征象表现为多发类圆性囊性病灶,双肺侵犯者者MRI征象表现为双肺多发大小为0.6~3.0cm的结节状实质钙化,肾侵犯MRI征象表现为囊性病灶周边沙粒样钙化。结论 MRI检查往往能揭示泡型肝包虫病患者肝脏和侵犯器官的典型表现,能够观察到病灶的数目、大小和形态、囊壁和内容物钙化,以及病灶部位与邻近器官的关系,可以帮助诊断与鉴别诊断。当MRI扫描发现患者肝脏有病变时,应重视对其好发侵犯脏器的检查,以降低漏诊和误诊率。

关键词: 泡型肝包虫病, 磁共振成像, 多脏器侵犯, 特征

Abstract: Objective To summarize the feature of magnetic resonance imaging(MRI) in patients alveolar hepatic echinococcosi (AHE) and complicated multiple organ invasion.Methods 210 patients with AHE were admitted to our hospital between February 2016 and January 2018,and all of them were confirmed by postoperational histopathologic examination. The imaging data of the patients were retrospectively analyzed,and the invasion features of MRI in brain,lung,and kidney were discussed.Results Out of the 210 patients with AHE,the hepatic lesions located in the left lobe,the right lobe and the left and right lobes were 26.2%,57.1% and 16.7%,respectively;the patients with brain invasion accounted for 12.9%,lung invasion for 17.1%,brain and lung invasion for 20.0%,brain and kidney invasion for 13.8%,and brain,lung and kidney invasion for 10.0%;the MRI feature of brain invasion presented with multiple round cystic lesions,that of lung invasion showed multiple 0.6 to 3.0 cm nodular parenchymal calcification,and the MRI sign of renal invasion was sand-like calcification around the cystic lesions. Conclusion The MRI examination has obvious advantages in diagnosis and differential diagnosis of patients with hepatic echinococcosis. We can observe the number,size and shape of the lesions,the calcification of the lesion wall and cystic contents,and the the adjacent organs involvement. We can also get information about the progress of the disease. Once the MRI scan shows that the patient has liver lesions,the attention should be paid to the examination of other important organs,such as brain,lung and kidney,so as to decrease the missed diagnosis.