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。

Study on the Value of CT Scan Combined with Dynamic Enhanced Scan in the Diagnosis of Alveolar Echinococcosis

Objective To study the value of CT scan combined with dynamic enhanced scan in the diagnosis of alveolar echinococcosis.Methods 61 cases of patients with alveolar echinococcosis confirmed by operation and pathology who were admitted in our hospital between January 2014 and June 2015 were studied. 22 cases underwent CT plain scan, and 39 underwent CT plain scan combined with multi-phase dynamic enhanced scan. With the results of surgical and pathological examination as the golden standard, the accuracy of clinical diagnosis was comparatively analyzed between the two groups. The imaging features of CT scan dynamic enhanced scan were analyzed.Results The diagnostic accuracy rate of CT plain scan combined with multi-phase dynamic enhanced scan (89.74%) significantly higher than that of CT (68.18%) (P<0.05). There was multiple cysticercerci in left and right hepatic lobe (alveolar echinococcus or Echinococcus granulosus). CT scan showed that there were some different sizes of low density cystic space-occupying lesions distributed in hepatic left (right) lobe and intracystic lower density shadow. The internal lesions were inhomogeneous and some were with hyperechoic nodules which can be explored. Multiphase dynamic enhanced scan showed small nodules or annular calcification; CT scan of alveolar echinococcus showed round, oval cystic masses and irregular low density shadow, with homogeneous density and obvious lesion mass effect. It also showed that there was patchy and sandy calcification, liver solid patches were abnormally enhanced, with bile duct invasion, portal vein shift caused by compression. CT scan of alveolar echinococcus complicated with infection showed there were irregular cystic masses in cystic dark region and lower density. Multiphase dynamic enhanced scan showed coagulative liquefying necrosis and cystic lesions and calcified tissue in depth, showing vacuole sign (small cyst).Conclusion The value of CT scan combined with dynamic enhanced scan in the diagnosis of alveolar echinococcosis is relatively higher. It can significantly improve the accuracy of clinical diagnosis and the imaging features are more obvious, which can provide enhanced information for clinical diagnosis and provide important basis for clinical diagnosis and treatment.