肝血吸虫病误诊肝癌CT与病理对照分析  

The Matched Control Analysis of Misdiagnosis Hepatic Schistosomiasis to Hepatocarcinoma by CT and Pathology

作　　者：李震[1] 胡道予[1] 张玉琴[1] 黄艳荣[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《肿瘤防治研究》2004年第10期639-641,共3页Cancer Research on Prevention and Treatment

基　　金：国家教育部回国人员科研启动基金资助项目(2 0 0 2 789);湖北省自然科学基金项目资助 (2 0 0 2AB130 )

摘　　要：目的　分析肝血吸虫病误诊为肝癌病例的基本CT特点 ,探讨避免误诊的途径。方法　 2 2例CT初诊为肝癌 ,经皮肝脏穿活检或手术证实为肝血吸虫病的患者 ,对肝血吸虫病的常见CT征象进行综合分析 ,并与病理结果相对照 ,探讨不典型的肝血吸虫病的CT特点。结果　 2 2例患者均出现肝叶比例失调和肝内结节病灶 ,并且 90 .91%的患者具有结节强化和肝裂增大的特点。 16例脾脏增大 ,2 1例汇管区有低密度灶。增强扫描强化以静脉期为主 ,且表现为边缘轻度环行强化 ,动脉期未见结节内供血动脉影 ,延迟期强化不明显。结论　不典型的肝血吸虫病 ,肝硬化征象和静脉期边缘轻度环行强化可能有一定的参考价值 。Objective To study the characteristics of liver schistosomiasis misdiagnosis hepatocarcinoma by spiral CT and research the methods to avoid misdiagnosis.Methods Twenty-two patients were diagnosis as “hepatocarcinoma” by spiral CT, but other radiology examinations did not agree with it. All the patients were performing partial hepatectomy or needle biopsy of liver. After the operations, we found there were not hepatocarcinoma but liver schistosomiasis by pathology. We analysis all the valuable CT signatures of the misdiagnosis patients. To research which signatures were more important in atypical liver schistosomiasis.Results All the 22 patients have liver lopsided development and nodules, and 90.91% patients have nodule reinforcement and liver fissure enlargement. 17 of 22 patients have splenomegaly and 20 of them have low density in confluence region. There were mild cycle reinforcements on the nodules edge in the portal vein stage, and no arteries reinforcement signs in the artery stage of the CT. There were slight reinforcements in the delay stage.Conclusion For atypical liver schistosomiasis, the signature of cirrhosis and nodule mild cycle reinforcements on the nodules edge in the portal vein stage may be hint liver schistosomiasis. The most economical and effect methods to diagnosis liver schistosomiasis is needle biopsy of liver.

关 键 词：肝血吸虫病 螺旋CT 误诊 

分 类 号：R816.5[医药卫生—放射医学]