37例肝包虫病的多层螺旋CT诊断分析

目的通过对肝包虫病的多层螺旋CT表现进行分析,提高肝包虫病诊断的准确率。方法回顾性分析本院经手术病理证实的37例肝包虫患者的CT表现,探讨多层螺旋CT在诊断肝包虫疾病中的价值。结果囊性包虫病16例,其中单纯囊肿9例,表现为圆形或类圆形低密度病灶,多发子囊型7例,表现为一个体积较大的母囊腔内多发沿母囊壁排列的小子囊,呈"车轮状"改变,钙化18例,表现为病变边缘的蛋壳样钙化、病灶内不规则点片状、条带状钙化、实质大部分钙化。泡状肝包虫3例,表现为大片不规则混杂密度病灶,呈"地图状"钙化。结论多层螺旋CT可显示肝包虫的大小、部位、形态及与周围组织的关系,提高诊断准确率,为手术提供可靠信息。     

肝脏及肺部泡状棘球蚴病CT表现（附11例肝肺病例报告）

目的分析肝脏及肺部泡状棘球蚴病的CT表现，探讨肝脏及肺部泡状棘球蚴痛的CT诊断及鉴别方法分析临床及手术病理证实的9例肝脏及2例肺脏泡状棘球蚴病螺旋CT表现。结果2例肺泡状棘球蚴病CT均表现为实性病灶，边缘清楚，未见钙化影。9例肝脏泡状棘球蚴病中5例表现为中心以实性为主周围伴有多发性小空泡征的圆形、椭圆形阴影，边缘光滑，其中3例囊肿壁有不同程度环形钙化。2例为实性病灶，部分囊壁环形钙化，囊内无小空泡征（小囊肿）。2例CT表现为斑块状低密度影，分界不清，中间散在分布斑点钙化影。结论螺旋CT可以很好显示肝肺泡状包虫病病灶，对肝肺泡状包虫病具有较高的诊断率。     

腹腔包虫的CT、MRI表现

目的：探讨腹腔包虫病的CT、MRI表现。方法：回顾性分析5年以来的10例腹腔包虫囊肿病的CT、MRI影像特点。结果：表现为单发4例;多发6例;单囊型4例,表现为圆形或椭圆形囊性肿块,壁略厚;6例病灶为多囊型,其中2例病灶囊肿壁有钙化。增强扫描包虫囊肿壁无强化。结论：CT、MRI对腹腔包虫病定位、定性有较高的诊断价值。     

肝包虫病的CT表现1例报道

1临床资料 　　患者,男性, 60岁,因畏寒,发热近 1个月来院就诊, B超及同位素显示肝囊性占位。 CT扫描示肝右叶后段有一 4.5cm× 3.8cm类圆形低密度影,边界清楚, CT值为 19.2HU,囊壁呈环形钙化,厚薄不均,囊内有小条状稍高密度影,增强后病灶无强化 (图 1)。 CT拟诊为①肝囊肿继发感染;②肝包虫囊肿;③肝脓肿。穿刺后病理诊断为肝包虫病。 2讨论 　　肝包虫病即棘球蚴病,有两种类型。一是细粒棘球绦虫虫卵感染引起的囊型包虫病;二是由多房棘球绦虫虫卵感染所致的泡型包虫病,后者仅占 1％～ 2％。细粒棘球蚴在肝内以包囊膨…     

螺旋CT对肝脏病变的临床诊断价值

目的:探讨螺旋CT对肝脏病变的临床诊断价值.方法:选取2012年1月-2012年11月间已确诊的肝脏病变患者63例,进行螺旋CT影像扫描并分析.结果:肝血管瘤病灶形态大多数为圆形或椭圆形,低密度且均匀,增强扫描以边缘向中心扩展;肝癌病灶呈圆形或类圆形状态,低密度,在病灶中心有时会出现更低密度,一般病灶边缘不清晰,有结节状;肝脓肿多数呈圆形或椭圆形,一般病灶边缘不清晰,呈现低密度,且不均匀,伴有不同密度的环状影像带;肝囊肿呈圆形或椭圆形,囊肿边缘较清晰明显,呈现低密度且均匀,一般无钙化;肝包虫病呈圆形或椭圆形,病灶边缘均较为清晰,低密度且均匀,均有钙化现象.结论:准确认识肝脏各种病变螺旋CT特征性表现,对快速准确诊断,具有较高的临床诊断价值.     

肝包虫病(CT检测所见)

患者，男性，32岁，新疆人。因右上腹不适胀感就医。B超检查：探及肝右叶6．9cm×5．1cm囊性占位病变。CT扫描检查：示历右叶后段区可见单发大小为6．09cm×5.20cm圆形低密度囊性病变，CT值29HU，边界光滑清楚，包腹部分吴新月形钙化．CT值376.5Hu，壁厚薄不均，但密民较高，CT值《70HU。囊肿内有更低密度的圆形影CT值近似水。囊内有钙化，CT值296Hll，小囊内无钙化。增强后扫描可见不同程度囊壁强化．相对的囊内密度略增高，同时有点状增强灶。肝内胆管无扩张。此病人凯松氏皮肤试验（casoni试验）阳性。肝包虫病为人有共患的寄生…     

肺包虫CT诊断

目的：探讨肺包虫病的CT影像特点,提高对该病CT诊断的认识。方法：回顾我院2001～2009年内就诊患者7例,均行胸部X线正侧位投照,并行CT扫描,且均经手术病理证实。结果：肺包虫病CT表现为,可单发或多发囊性病灶,单发较多,5例为单发囊性病灶,2例为多发囊性病灶,病灶呈圆形或椭圆形,边缘清晰锐利,右肺较多见,囊内密度均匀一致,比较典型的征象为囊内子囊。1例合并感染及囊壁钙化。合并感染时内部密度可不均匀增高,外囊壁可见弧形或蛋壳状钙化,囊内可见无定形条片状钙化,并可见＂新月征＂、＂双边征＂、＂水上荷花征＂及＂飘带征＂。结论：肺包虫在CT影像上的表现比较有特征性,能较好地显示病变及并发症,因此CT在肺包虫病的定性诊断中具有较高的价值。     

囊性肾细胞癌的动态增强CT表现

目的：探讨单房囊性和多房囊性肾细胞癌的动态增强CT表现特征,以提高其诊断准确性。方法：经手术病理证实的8例囊性肾透明细胞癌术前均行螺旋CT平扫及增强皮髓交界期、实质期、排泄期扫描;分析每一肿瘤的囊壁、囊内间隔、壁及隔结节的平扫,尤为动态增强CT表现。结果：8例囊性肾透明细胞癌中,多房囊性者6例,单房囊性者2例。CT平扫所有肿瘤均表现为肾实质内圆形或分叶状低密度囊性病变。部分病灶突向肾轮廓外：囊内密度不均7例;5例可见囊壁和／或内隔,其中囊壁不规则增厚和,或有结节者3例,3例伴有囊壁和,或内隔钙化。多期动态增强检查,与平扫相比囊壁、内隔、结节显示更为清楚;7例显示囊壁、内隔、壁结节发生不同形式的强化,其中,4例呈快进快退型强化,3例呈轻至高度进行性延迟强化;1例因囊壁钙化,有无强化分辨不清。结论：囊性肾细胞癌的CT动态增强表现具有一定特征,有助于正确诊断,但表现不典型者,还需与其他肾脏良性囊性疾病相鉴别。     

子宫圆韧带囊肿的多层螺旋CT诊断价值

目的探讨多层螺旋CT在子宫圆韧带囊肿诊断中的临床应用价值。方法回顾性分析13例经手术及病理证实的子宫圆韧带囊肿患者的CT及临床资料,所有病例均采用多层螺旋CT容积扫描,结合轴位、冠状及矢状位多平面重建(MPR)图像,加局部薄层及曲面重建(CPR)图像。结果 CT表现特点:沿子宫圆韧带走行区梭形、椭圆形囊性包块,囊壁薄而光滑,11例囊内密度均匀,CT值5-12Hu;4例伴囊壁钙化,11例清楚显示子宫圆韧带走行与包块相连。结论多层螺旋CT密度分辨率高、显示解剖关系清楚,对子宫圆韧带囊肿的诊断具有较高的临床应用价值。     

CT平扫结合动态增强扫描在诊断肝泡型包虫病中的价值研究

目的研究CT平扫结合动态增强扫描在诊断肝泡型包虫病中的价值。方法选取我院收治的经过手术及病理证实为肝泡型包虫病的患者61例,其中22例行CT平扫,39例行CT平扫加多期动态增强扫描,以手术病理检查结果为金标准,对比分析两组患者临床诊断准确率,并分析患者CT平扫加多期动态增强扫描的影像特征。结果CT平扫加多期动态增强扫描检查诊断准确率89.74%明显较CT平扫准确率68.18%高(P0.05)。肝左右叶多发包囊虫(泡状棘球蚴或细粒棘球蚴)CT平扫可见肝左(右)叶散在多个大小不等的低密度囊性占位,囊内可见更低密度影,病变内部不均,部分可探及强回声结节,多期动态增强扫描可见小结节或环状钙化;泡型肝包虫病CT平扫可见圆形、椭圆形囊性包块,不规则低密度影,密度均匀,病灶占位效应明显,多期动态增强扫描可见斑块状、沙粒状钙化,肝实质斑片状异常强化,胆道受侵,门静脉受压推移;肝包虫并感染CT平扫可见内部有囊性暗区的不规则囊性包块,可见更低密度,多期动态增强扫描可见凝固性液化坏死囊变,有钙化组织深入,呈"小泡征"(小囊肿)。结论 CT平扫结合动态增强扫描在肝泡型包虫病中诊断价值较高,可显著提高临床诊断率,且影像表现特征更明显,对临床诊断具有增强信息的作用,可为临床诊断与治疗治提供重要的参考依据。     

34例肝包虫CT诊断与分析

目的探讨肝包虫病的CT表现特征和病理基础,评价CT对肝包虫病的诊断价值。方法34例经手术病理证实的肝包虫患者,对其术前CT资料作回顾性对照分析。结果34例肝包虫诊断正确33例,误诊l例,诊断正确率为97．05％。结论肝包虫病有特征性的CT表现,CT可反映肝包虫不同时期的特征性病理改变,有很高的诊断价值。     

磁共振水成像技术在包虫病诊断中的应用

目的：探讨磁共振水成像（MRH）技术在包虫病诊断中的作用，以利于临床手术方案的制定和预后的评估。方法：69例包虫病患者中47例为细粒棘球蚴病，22例为泡状棘球蚴病，69例均行常规MR和MRH检查。结果：47例细粒棘球蚴病中31例为单囊，MRH显示更清晰，16例为多子囊，12例多子囊的110个子囊中，MR普通检查检出率为56．36％，MR水成像检出率为98．18％。MR水成像检出的病灶明显多于MR普通检查检出的病灶。16例泡状棘球蚴病中MR普通检查共发现68个病灶，磁共振水成像技术共发现123个病灶。结论：MRH结合常规磁共振检查可显示包虫病自身的精细结构，并可获得更多包虫病与临近结构关系的信息，二者结合在包虫病的诊断方面具有许多优势，尤其是对合并并发症的复杂类型的包虫病的诊断。     

Clinical Experience in Treating Intracranial Hydatid Cysts: Report of 97 Cases

Background: Echinococcosis is still endemic in many countries, including China, especially in its north-west part, but the world literature which describes the Chinese experience in treating the cerebral hydatid cyst is still lacking. In this report, clinical manifestations, radiological features and surgical outcomes of 97 patients with intracranial hydatid cysts were analyzed and the transmission pattern, preoperative diagnosis, treatment methods and long-term outcome were discussed. Methods: We retrospectively reviewed the clinical features ( neurological symptoms and signs), radiological manifestations( X-ray, CT, MRI) and surgical outcome of 97 patients with intracranial hydatid cysts whom received surgical treatment at the neurosurgical department of Xinjiang Medical University between the year 1985 to 2010.We have followed up the patients via sending questionnaire or telephone contact. Clinical outcome was evaluated by using Karnofsky Performance Scale Index (KPSI). Results: Headache and vomiting were the most common initial symptoms in our patients. Neurological deficits caused by the mass effect of the cysts were seen in 82 cases, which include hemiparesis, visual deficit, diplopia and aphasia. Epilepsy was occurred in five patients with hemispheric hydatid cysts. On X-Ray, significant bone erosion was seen in only two cases with epidural hydatid cysts. Round shaped and thin walled homogeneous low-density cystic lesion without surrounding edema and enhancement were the main findings on CT in 95 patients with intraparenchymal hydatid cysts, while two cases with epidural hydatid cysts were manifested as a heterodensity lesions. On MRI, Hydatid cyst was manifested as a round low signal lesion in T1-Weighted images and high signal lesion in T2-weighted images, without enhancement after contrast media injection, while the two cases with epidural cysts were manifested as mixed signal masses. Surgical removal of cyst was performed in all cases. Total removal was achieved in 93 cases without rupturing the cyst wall. Only two cysts ruptured during the dissection, resulted in two surgery related mortality. There was no other additional neurological deficit caused directly by surgery. Patient outcome was 97.2% with Karnofsky Performance Scale score 80 to 90. Conclusion: Intracranial hydatid cyst is still a main cause of increased intracranial pressure among the patients in endemic areas. CT and MRI have been proven to be the best diagnostic modality for diagnosing intracranial hydatid cyst. Surgery is the treatment of choice for intracranial hydatid cyst whenever possible.     

肺包虫囊肿的影像学诊断

本文总结了４５８例肺包虫囊肿影像学诊断经验。典型Ｘ线征除罕见的环形囊壁鲈化外,只有破裂后形成液平面,上有漂浮膜或内囊周围有液体及气体形成双液平面。ＣＴ扫描包虫囊肿密度均匀,ＣＴ值２０Ｈｕ以下,偶见囊中之囊。Ｂ超声囊肿呈圆形或椭圆形无回声区。     

肾包虫囊肿的CT诊断(附3例报告)

本文报告经手术证实的3例肾包虫囊肿的CT表现。其特征性表现是:(1)卵圆形或圆形水样密度囊肿。(2)母囊内有子囊。(3)囊膜剥离征象。(4)囊壁钙化。并讨论了本病的破裂感染和与先天性肾囊肿的鉴别诊断。     

鞍区囊性病变影像学诊断

目的:探讨鞍区囊性病变的CT和MR I表现,提高对该类疾病的诊断和鉴别诊断水平。方法:收集经手术病理与临床证实的鞍区囊性病变的CT和/或MR I资料72例,其中囊性垂体瘤12例,囊性颅咽管瘤25例,Rathke囊肿16例,蛛网膜囊肿4例,鞍上池下疝继发假性蛛网膜囊肿4例,鞍旁表皮样囊肿4例,鞍旁皮样囊肿3例,垂体脓肿4例。全部病例均行CT和/或MR I平扫,其中14例行CT增强检查,58例行MR I增强检查。72例中65例经手术病理证实,7例经临床证实。结果:12例囊性垂体瘤,其中垂体大腺瘤8例,微腺瘤4例。6例大腺瘤表现为在实性瘤体内出现囊变区,2例瘤卒中囊变区内可见液平。4例囊性垂体微腺瘤显示垂体饱满,内部出现异常信号/密度,伴有化验室检查异常。25例囊性颅咽管瘤以囊性表现为主,发现囊壁钙化及强化的垂体对鉴别诊断有意义。16例Rathke囊肿信号多样,但以形态饱满,呈短T1、长T2信号为较具特征性的改变。4例蛛网膜囊肿和鞍上池下疝继发假性蛛网膜囊肿均表现为脑脊液信号,而后者囊壁出现连续或不连续薄壁环形强化,为其特征性表现。3例皮样囊肿密度/信号较表皮样囊肿复杂,压脂序列对两者鉴别诊断有帮助。4例垂体脓肿增强均显示环形强化,结合临床病史有助于术前诊断。结论:鞍区不同性质的囊性病变具有一定的影像学特点,通过详细的影像学检查可对其中多数病变做出正确的定性诊断。     

48例肝包虫病诊治体会

目的探讨48例肝包虫患者的诊治体会。方法对1999-01~2005-06间收治的48例肝包虫病例资料进行回顾性分析。方法:外囊缝团术(8例),内囊摘除外囊缝合引流术(30例),网膜填塞术(10例)等处理方法。结果术后合并胆漏29例,均自愈。目前未见复发的病例,48例患者均获满意疗效。结论肝包虫病治疗以外科手术治疗为主,穿刺需谨慎,术中根据不同的情况采取不同的、合理的措施,可以获得满意的治疗效果。     

肝包虫声象图特征与手术所见对照分析

对宁夏区人民医院自１９８４年４月至１９９２年６月超声诊断并经手术及病检证实的５４例肝包虫病进行分析和分型。作者同意，肝包虫病有不少声象图结构特征，如囊肿壁厚在０．３ｃｍ以上，部分呈现双边征，囊肿内有带状强回声分隔或有点状强回声漂浮；有的包虫囊肿呈现为类实型肿物等等。参照有关资料，作者将本病分为各有其独特声象图特征的五个型，即１）单囊型，２）多发囊肿型，３）内囊分离型，４）子囊孙囊型，５）类实型；其中的３）内囊分离型共１６例。     

Clinics in diagnostic imaging (102)

A 19-year-old man presented with cough and haemoptysis of ten days duration. He also had mild right hypochondrial pain. Chest radiograph and computed tomography (CT) showed a rounded soft tissue density opacity with an air crescent sign. CT showed multiple cystic lesions in the liver with a daughter cyst in its lateral wall. Diagnosis of hydatid disease of lung and liver was made. The contents of the liver cyst were aspirated, hypertonic saline instilled, re-aspirated, and absolute alcohol injected. Hydatid disease is endemic in certain parts of the world. Although the lungs and liver are most frequently affected, the disease can arise in any part of the body and should be kept in differential diagnosis whenever a cystic lesion is encountered. Hydatid cysts typically demonstrate characteristic imaging findings, however, the appearances may become complicated due to cyst rupture or secondary infection. Ultrasonography is the imaging modality of choice particularly in hepatic disease. CT best demonstrates cyst wall calcification and cyst infection.