脑囊尾蚴病患者治疗后脑CT影像学特征变化  

Changes of brain CT imaging of cerebral cysticercosis patients during the period of anti-cysticercus chemotherapy

作　　者：胡颖新[1] 贾凤菊[1] 台桦 于振华[1] 戴军[3] 于涛[1] HU Ying-xin;JIA Feng-ju;TAI Hua;YU Zhen-hua;DAI Jun;YU Tao(Shandong Institute of Parasitic Diseases,Shandong Academy of Medical Sciences,The Third Affiliated Hospital of Shandong Academy of Medical Sciences,Jining 272035,China;Jining Health School,Shandong Province,China;Institute of Immunology and Molecular Medicine,Jining Medical University,China)

机构地区：[1]山东省医学科学院、山东省寄生虫病防治研究所、山东省医学科学院第三附属医院,济宁272033 [2]山东省济宁卫生学校 [3]济宁医学院免疫学教研室

出　　处：《中国血吸虫病防治杂志》2018年第5期523-526,547,共5页Chinese Journal of Schistosomiasis Control

基　　金：山东省济宁市科技局立项课题(2009-56-34);山东省自然科学基金(ZR2013HL014)

摘　　要：目的探讨脑囊尾蚴病患者抗囊尾蚴治疗期间脑CT影像变化。方法选择2010年5月至2015年5月在山东省医学科学院第三附属医院就诊的380例脑囊尾蚴病住院患者作为研究对象,临床给予3阶段阿苯达唑、吡喹酮抗囊尾蚴化疗,治疗前后均行头颅CT扫描,其中210例行增强扫描,对治疗不同阶段患者脑CT影像学资料进行分析。结果脑囊尾蚴病患者治疗前CT影像显示有单个或多个小囊状低密度,囊内可见小结节状高密度头节影,伴周围水肿;治疗后脑CT复查显示81.58%(310/380)的脑囊尾蚴病患者低密度灶完全吸收,16.32%(62/380)病灶大部分吸收,2.11%(8/380)CT影像显示为钙化灶。患者一般于服用抗囊尾蚴药物2~3 d后出现杀虫反应;随着治疗时间的延长,抗囊尾蚴药物反应逐渐减轻,在第3阶段治疗后大多数患者病灶吸收或钙化。结论 CT检查可明确脑囊尾蚴病病变部位、范围,并可对脑囊尾蚴病进行分型,还能根据抗囊尾蚴治疗期间影像学变化评价治疗效果。Objective To investigate the changes of brain CT imaging in patients with cerebral cysticercosis during the period of anti-cysticercus chemotherapy.Methods A total of 380 inpatients that were conformed to the practical diagnostic criteria of cerebral cysticercosis were enrolled in this study in the Third Affiliated Hospital of Shandong Academy of Medical Sciences from May 2010 to May 2015.All the patients were given anti-cysticercus chemotherapy (albendazole and praziquantel).All the patients received brain CT scan,and of which 210 received enhanced scan.The data of CT imaging were systematically reviewed.Results Before the treatment,the CT images of the patients showed single or multiple small cystic (s)with low density and small nodule-like cephalomere with high density.The re-examinations of CT showed that there were 81.58%(310/380)of the patients whose low density foci were completely absorbed,there were 16.32%(62/380)of the patients whose loci were most- ly absorbed,and there were 2.11%(8/380)of the patients whose foci were calcified.Along with the prolongation of treatment time,the side effects were gradually reduced,and in the third course of treatment,the foci were absorbed or calcified in most of the patients.Conclusion CT examination can diagnose the lesion site,range and classification of cerebral cysticercosis,and can evaluate the effect of the therapy according to the changes of CT imaging during the period of anti-cysticercus chemotherapy.

关 键 词：脑囊尾蚴病 抗囊尾蚴治疗 体层摄影术 影像学特征 杀虫反应 

分 类 号：R532.33[医药卫生—内科学]