慢性血吸虫病腹部CT表现与病理基础

目的分析慢性血吸虫病患者的腹部CT表现。方法对确诊的42例慢性血吸虫病患者均行腹部CT平扫+增强扫描,并对手术切除或活检组织样本进行病理检查。结果 CT扫描中肝硬化36例,肝左叶增大21例,不同形态钙化影32例,分隔状钙化为主19例,肝实质不均匀强化40例;脾肿大19例,脾脏钙化7例;大肠壁增厚伴钙化21例,表现为全管壁较均匀增厚,伴线状、轨道状钙化,其中全结肠钙化2例,降结肠、乙状结肠及直肠钙化8例,乙状结肠直肠钙化9例,直肠钙化2例,并发结肠癌2例;门静脉及其属支钙化14例,合并肝脏转移瘤癌1例,合并胆囊结石12例,合并腹水5例。病理标本镜检示病例肝内不同程度纤维化,纤维间隔增生,内见钙化虫卵沉积;大肠壁纤维增生,见较多钙化虫卵沉积,合并腺癌者肿瘤组织内见钙化虫卵沉积;脾脏内未见虫卵沉积,胆囊壁见少量虫卵沉积。结论慢性血吸虫病腹部CT表现为多脏器损害,不同形态钙化影是其主要影像特征。

CT manifestation of abdomen and its pathology of patients with chronic schistosomiasis

Objective To understand the abdominal CT manifestation and its pathology of patients with chronic schistosomiasis.Methods The plain + enhanced CT scanning was performed in 42 patients with chronic schistosomiasis,and their tissues of biopsy and surgical resection were examined pathologically.Results Among the 42 patients,schistosomiasis cirrhosis of liver was found in 36 cases,left lobe enlarged was found in 21 cases,and calcification was found in 32 cases.Portal vein and its tributaries calcification were found in 14 patients,and one of them was accompanied with transplanted hepatocellular carcinoma,12 patients with stones in gallbladder,and 5 patients with ascites.Among the 19 patients with splenomegaly,7 patients were accompanied with calcification.Intestinal wall thickening with linear and tram-like calcification was seen in 21 cases.Descending colon,sigmoidcolon,and rectum calcifications were found in 8 cases,and rectosigmoid calcification was found in 9 cases,rectum calcification was seen in 2 cases,and 2 patients were accompanied with colon carcinoma.The pathological examination showed fibrosis and calcified ova in liver,large intestine and gallbladder of the patients,but there were no ova in spleen.Conclusion Abdominal CT manifestation of patients with chronic schistosomiasis presents the damage of multiple organs in abdomen,and various calcifications are the main image characteristics.