白血病肝脏真菌感染的CT表现  

CT Findings of Fungal Liver Infection in Leukemia Patients

作　　者：杨旭峰[1] 郭欢仪[2] 周丽莎[1] 胡晓书[1] 朱洪章[1] 李子平[1] 冯仕庭[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]中山大学附属第三医院超声科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2014年第5期786-790,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学青年基金(81000626);广东省自然科学基金(S2013010016004);珠江科技新星专项基金(2012J2200084);中央高校基本科研业务费专项资金(10ykpy11)

摘　　要：【目的】白血病合并肝脏真菌感染的病例比较罕见,本文通过总结经病理证实的病例的CT表现特点,以期提高对该病诊断的准确性。【方法】收集16例经病理确诊的白血病合并肝脏真菌感染的临床与影像学资料,全部患者均行上腹部CT平扫及双期增强扫描,回顾性分析其CT表现。【结果】16例中CT发现肝肿大9例(56%)。肝内病灶CT表现分5型:Ⅰ型,单纯低密度型,平扫、动脉期呈低密度,门脉期呈低或等密度;Ⅱ型,环征,动脉期边缘强化,门脉期为等密度;Ⅲ型,靶征,动脉期中央呈小结节状强化,周围见低密度环,外周环状强化;门脉期低密度环不均匀强化,外周强化环消退;Ⅳ型,牛眼征,动脉期和门脉期边缘强化,内部为低密度;Ⅴ型,多结节融合呈花瓣状肿块。本组16例中,I型1例、Ⅱ型7例、III型5例、IV性1例、V型1例,1例出现为II型及III型。【结论】白血病肝脏真菌感染的CT表现有一定特征性表现,CT有助于早期诊断并疗效监测。[Objective] Fungal liver infection in leukemia patients are extremely rare.The purpose of the study was to improve the diagnostic efficacy of CT for such diseases by summarizing the CT features of fungal liver infection in leukemia patients proved by pathology.[Methods] Sixteen leukemia patients with fungal liver infection proven by pathologically were collected and underwent nonenhance and enhance CT scanning,retrospectively analyze the characteristics of CT findings.[Results] Nine patients suffered hepatomegaly （56％）.Based on CT findings,five different types of lesions were found：Type Ⅰ showed simple low density lesions during unenhanced phase,lack of enhancement during HAP and slight enhancement during PVP.Type Ⅱ showed ring sign,edge enhancement during HAP was found,but it would be equal density during PVP.Target sign was the main character of Type Ⅲ,and bull eye sign was found in type Ⅳ,while Type Ⅴ appeared as petal form multinodular confluent tumor.In all 16 patients,Type Ⅰ （1/16）,Type Ⅱ （7/16）,Type Ⅲ （5/16）,type Ⅳ（1/16）,and Type Ⅴ （1/16） were found,while 1 patient image contained Type Ⅱ and Type Ⅲ simultaneously.[Conclusions] Fungal liver infection in leukemia showed certain pattern on CT imaging,and CT would contribute to early diagnose and monitor the efficacy of treatment.

关 键 词：白血病 真菌感染 体层摄影术 X线计算机 肝 

分 类 号：R814[医药卫生—影像医学与核医学]