常见食源性寄生虫肝脏感染的影像学表现  

CT and MR Features of Hepatic Infection Caused by Foodborne Parasitosis

作　　者：高茜 严俊[1] 何波[1] 曾小敏 胡纯章 GAO Qian;YAN Jun;HE Bo(Department of Medical Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650031,P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科

出　　处：《临床放射学杂志》2019年第11期2086-2090,共5页Journal of Clinical Radiology

摘　　要：目的探讨肝脏常见食源性寄生虫感染的影像学表现,以提高诊断水平。方法搜集25例肝脏食源性寄生虫感染患者的CT和MR平扫及增强资料,分析其影像学表现。结果25例患者肝脏病灶呈多发性分布,以肝包膜下为主,沿门静脉及胆管周围分布。13例CT及24例MR扫描,病灶呈类圆形、结节状,呈"簇状"分布,CT上呈不均匀低密度,MRI呈长T1、长T2信号,21例病灶周围出现T2低信号环,14例T1WI上见稍高信号,DWI信号多变,增强门静脉期病灶呈"蜂窝状"改变,6例CT及15例MRI患者出现"迂曲轨道征";3例出现包膜下或膈下强化结节,8例出现包膜强化。7例胆管扩张,4例肝门区淋巴结肿大。结论肝脏食源性寄生虫感染的病理变化,在影像学上可以有特征性的表现,结合临床及实验室相关检查,确诊食源性寄生虫的可靠性将大大提高。Objective To study CT and MR features of hepatic infection caused by foodborne parasitosis and to improve the diagnostic accuracy. Methods A total of 25 patients with foodborne parasitosis infection in the liver were enrolled in this study. The plain and dynamic enhanced CT or MR scans were performed,then the imaging features were analyzed. Results Multiple lesions were seen in 25 cases,which were distributed in the peripheral region and along the portal vein and bile ducts of the liver.13 cases of CT scan and 24 cases of MR scan showed round,nodular,clustered lesions. On CT plain scan,they were heterogeneously low density;On MR scan,they were hyperintense on T2WI and hypointense on T1WI,and 21 cases showed low intensity circles on T2WI. On T1WI,hyperintense lesions were observed in 14 cases. DWI had various signal. All lesions showed inhomogeneous enhancement on portal vein phase,and presented honeycomb-like and "track sign"(6 CT cases and 15 MR cases) enhancement. Sub-capsular or subphrenic nodules were found in 3 cases. 8 cases had liver capsule enhancement,7 cases had cholangiectasis and 4 had abdominal lymphadenopathy. Conclusion Hepatic infection caused by foodborne parasitosis has characteristic CT and MR features. Combined with clinical examination and laboratory test,the reliability of diagnosis will be considerably increased.

关 键 词：肝脏感染 寄生虫 体层摄影术 X线计算机 磁共振成像 

分 类 号：R53[医药卫生—内科学] R575[医药卫生—临床医学] R445.2