肝外转移肝泡型包虫病的CT特征分析  

CT features analysis of hepatic alveolar echinococcosis with extrahepatic metastasis

作　　者：龙丹丹 尹桂秀[1] LONG Dandan;YIN Guixiu(Imaging Center,the Affiliated Hospital of Qinghai University,Xining 810001,China)

机构地区：[1]青海大学附属医院影像中心,青海西宁810001

出　　处：《实用放射学杂志》2021年第8期1302-1305,1309,共5页Journal of Practical Radiology

摘　　要：目的探讨肝泡型包虫病(HAE)发生肝外转移的肝内病灶的CT影像学特征。方法选取经临床及影像诊断或确诊的HAE患者290例,根据检查结果及临床诊断结果,分为肝外转移组(124例)和非肝外转移组(166例)。分析2组间年龄、性别的差异,基于CT图像分析2组间肝内病灶分型、钙化形态、最大直径、病灶位置、范围、数量,肝静脉、门静脉、胆管、肝脏周边脏器或组织受侵、腹水量情况。所得数据导入SPSS24.0软件进行统计学分析。结果肝外转移组124例中发生单一肺部转移58例(46.8%)、单一脑部转移21例(16.9%)、其他脏器单一部位转移(如脊柱、腹膜后淋巴结、肋骨等)9例(7.3%),2处或2处以上部位转移36例(29.0%)。2组间肝内病灶病灶平均最大直径、肝脏1、2、4、5、6、7、8段受侵的阳性率、肝内3个及3个以上肝段受侵的阳性率、肝内出现2个或2个以上病灶的阳性率、肝脏周边脏器或组织受侵的阳性率的差异有统计意义(P<0.05);病灶对门静脉右支、门静脉主干、肝右静脉、肝中静脉、下腔静脉肝内段、肝内胆管左支及右支以及肝总管侵犯的阳性率的差异有统计学意义(P<0.05)。结论发生肝外转移的HAE患者其肝内病灶更多的侵犯肝脏右叶及尾状叶,其病灶直径更大,肝内病灶数量更多,病灶侵犯肝内外血管、胆管或其他相邻组织脏器更多、更严重。这些影像学征象有助于提示HAE发生肝外转移的可能。Objective To analyze the CT characteristics of hepatic alveolar echinococcosis(HAE)with extrahepatic metastasis.Methods Totally 290 patients with HAE were collected who were diagnosed or confirmed by clinical and imaging diagnosis.Based on the clinical resultsfall patients were divided into extrahepatic metastasis group(124 patients)and non-extrahepatic metastasis group(166 patients).The differences in age and gender,the types of intrahepatic lesions,calcification morphology,maximum diameter,location,range and number of lesion,invasion to hepatic vein,portal vein,bile duct peripheral organ or tissue of the liver,and the volume of ascites on CT images between the two groups were analyzed.Results Among the 124 patients of extrahepatic metastasis group,there were 58 cases(46.8%)with single pulmonary metastasis,21 cases(16.9%)with single brain metastasis,9 cases(7.3%)with single site metastasis in other organs except lung and brain(such as spine,retroperitoneal lymph node,ribs,etc.)and 36 cases(29.0%)with two or more sites of metastasis.The differences in the mean maximum diameter of intrahepatic lesions,the positive rate of invasion of liver segments of 1,2,4,5,6,7 and 8,the positive rate of invasion of three or more hepatic segments,the positive rate of two or more intrahepatic lesions,and the positive rate of invasion of peripheral organs or tissues of the liver between the two groups were statistically significant(P<0.05).There were statistically significant differences in positive rates of invasion of right branch of portal vein,portal trunk,right hepatic vein,middle hepatic vein,intrahepatic segement of inferior vena cava,right and left intrahepatic bile duct and common hepatic bile duct caused by lesions(P<0.05).Conclusion The HAE patients with extrahepatic metastasis have more intrahepatic lesions that commonly invade the right lobe and caudate lobe,and the lesions presented larger diameter and more severe invasion to vessel,bile duct or other adjacent tissue.These are helpful to indicate the possibility of e

关 键 词：肝泡型包虫病 计算机体层成像 

分 类 号：R532.32[医药卫生—内科学] R575[医药卫生—临床医学]