肺炎克雷伯菌性肝脓肿的CT表现分析  

CT manifestations of pyogenic liver abscesses caused by Klebsiella pneumoniae

作　　者：张翔[1] 阚志超[2] 段樱[3] 邸阜生[4] 金二荣[4] 

机构地区：[1]天津市第三中心医院放射科CT室,天津300170 [2]天津市第三中心医院感染管理科,天津300170 [3]天津市第三中心医院检验科细菌室,天津300170 [4]天津市第三中心医院代谢病科,天津300170

出　　处：《中华医院感染学杂志》2012年第21期4806-4808,共3页Chinese Journal of Nosocomiology

摘　　要：目的观察和分析肺炎克雷伯菌引起的化脓性肝脓肿CT表现特点。方法对105例细菌性肝脓肿病例进行增强CT检查,并对病灶大小、数目、肝叶分布、囊实性、单/多房以及病灶内是否含气等表现进行记录、比较。结果 105例中52例为肺炎克雷伯菌性肝脓肿,53例为其他病原菌引起的肝脓肿;两组肝脓肿的CT表现肺炎克雷伯菌性肝脓肿呈实性表现的25例,其他病原菌肝脓肿实性者14例,分别占48.08%和26.42%(P=0.022);肺炎克雷伯菌性肝脓肿呈多房性改变的27例,其他病原菌肝脓肿多房性者17例,分别占51.92%和32.08%(P=0.039);肺炎克雷伯菌性肝脓肿病灶内不含气的有44例,其他病原菌肝脓肿病灶内不含气的有30例,分别占84.62%和56.60%(P=0.002);在两组病例中脓肿大小、数目、肝叶分布上差异无统计学意义。结论相比于其他病原菌引起的肝脓肿,单纯肺炎克雷伯菌性肝脓肿的CT表现特征为实性、多房性和病灶内不含气。OBJECTIVE To observe and analyze the characterized CT manifestations in patients with pyogenic liver abscesses caused by Klebsiella pneumoniae.METHODS Contrast-enhanced CT scan was performed for 105 patients with pyogenic liver abscesses,the CT characteristics of abscess including size,number,distribution,cystic or solid appearance,unilocular or multilocular appearance,and gas in cavity were recorded and compared.RESULTS Monomicrobial K.pneumoniae liver abscesses were present in 52 cases,the remaining 53 cases of abscesses caused by other pyogenic bacteria.On CT images,the characteristics more likely to be correlated with K.pnumoniae liver abscesses than other abscesses were a solid（25 cases vs 14 cases,48.08% vs 26.42%,P=0.022）,multilocular abscess（27 cases vs 17 cases,51.92% vs 32.08%,P=0.039）with lesser presence of gas（44 cases vs 30 cases,84.62% vs 56.60%,P=0.002）,but there were no statistically significant differences in the size and number of liver abscesses and the distribution of liver lobes.CONCLUSION As compared with the liver abscesses caused by other pathogens,monomicrobial K.pneumoniae liver abscesses appear as solid,multilocular mass without gas in it on CT examination.

关 键 词：肺炎克雷伯菌 CT 肝脓肿 

分 类 号：R378.996[医药卫生—病原生物学]