肺泡状棘球蚴病的CT表现特征

目的 分析肺泡状棘球蚴病的CT表现特征,评价CT诊断该病的价值.方法 回顾性分析26例经病理确诊或临床综合诊断为肺泡状棘球蚴病的CT表现特征及各种表现的病理基础.结果 双肺多发病灶18例,一侧肺多发病灶6例,双肺单发病灶2例.其中病灶为肿块结节混合型17 例,结节型8例,1例为单发肿块.26例中24例病灶边缘可见分叶状或锯齿状突起,13例病灶内可见不规则空洞、空泡,18例病灶内可见钙化,14例病灶邻近的肺组织内见到少量斑片或条索影,20例邻近胸壁的病灶处胸膜增厚明显,病灶以宽基底与胸壁相贴.结论 肺泡状棘球蚴病有较明显的CT表现特征,CT检查能为该病的诊断提供重要价值.

Abstract：

Objective To analyze the CT features of lung alveolar echinococcosis and assess the value of CT scanning for the diagnosis of this disease. Methods The CT features of lung alveolar echinococcosis in 26 patients diagnosed pathologically or clinically were reviewed retrospectively and correlated with histopathology.Results Lung alveolar echinococcosis appeared as multiple lesions bilaterally in 18 patients, as multiple lesions unilaterally in 6 patients, and as single lesion bilaterally in 2 patients. Seventeen cases presented as masses and nodules,8 patients presented as nodules,1 patient presented as a mass. Lobulation and spiculation were showed in most lesions, irregular cavity or bubble-like opacity in 13 patients,calcification in 18 patients,a patchy area or fibrotic cord around lesion in 14 patients. Pleural thickening adjacent to the lesion in 20 patients. Conclusion Lung alveolar echinococcosis has characteristic features on CT, and CT can provide important information for the diagnosis of lung alveolar echinococcosis.     

CT严重指数、超声造影联合血清降钙素原评估AP疗效

背景超声具有无创简便等优点,在急性胰腺炎病诊治中发挥着重要作用,而超声造影能通过分析胰腺微循环血流灌注,评估其缺血坏死状态,为临床诊治提供血流动力学信息.目的探讨超声造影联合血清降钙素原(procalcitonin,PCT)在评估急性胰腺炎(acute pancreatitis,AP)病情和疗效中的应用价值,及其与CT严重指数(CT severity indices,CTSI)的相关性.方法选取在我院接受治疗的AP患者作为研究对象,共63例,其中轻症AP患者38例(轻症AP组),重症AP患者25例(重症AP组).所有患者治疗前后测定血清PCT水平,行胰腺超声造影及腹部多层螺旋CT检查,记录超声造影严重指数(ultrasound severity indices,USSI)及CTSI,分析超声造影联合PCT评估疗效的可行性.结果超声造影诊断轻症AP患者37例,重症AP患者26例,敏感度=92.00%(23/25),特异度=92.11%(35/38);准确率=92.06%(58/63);重症AP组的血清PCT水平、USSI及CTSI明显高于轻症AP组,差异均有统计学意义(P<0.05);不同治疗结局组间的血清PCT水平、USSI及CTSI比较,差异均有统计学意义(P<0.05);治疗后患者血清PCT水平、USSI分别与CTSI呈正相关(r=0.803,0.951,均P<0.05);治疗后患者血清PCT水平、USSI分别与临床疗效呈负相关(r=-0.721,-0.836,均P<0.05).结论超声造影能有效显示胰腺组织缺血坏死状态,准确反映AP病情,联合血清PCT水平可为临床全面准确评估AP病情及预后提供有价值的参考.