脑血吸虫病的CT诊断(附12例分析)

目的进一步探讨脑血吸虫病的临床CT表现,提高诊断水平。方法回顾分析经手术病理或临床抗血吸虫治疗随访证实的12例脑血吸虫病人的CT平扫和增强扫描影像资料。结果12例均位于幕上,其中2例同时累及小脑;12例中脑炎型4例,肉芽肿型5例,混合型2例,脑萎缩型1例。脑炎型CT平扫表现为白质低密度,增强后低密度区内斑点及结节状强化;肉芽肿型CT平扫为低密度区内等密度影,增强示多个小结节融合成块状强化。结论脑血吸虫病病理类型不同临床及CT表现各异,早期以脑炎型为主,抗血吸虫治疗可以治愈,晚期形成较大的血吸虫肉芽肿,需手术治疗。CT早期诊断及随访复查极为重要。

CT diagnosis of intracerebral schistosomiasis (with ananlysis of 12 cases)

Objective To study the clinical manifestations and CT findings o f cerebral schistosomiasis and improve the diagnosis. Methods Non-enhanced and co ntrast enhanced CT images of 12 patients with cerebral schistosomiasis were anal yzed retrospectively, and all cases were confirmed by open surgery followed by p athological examination or clinical follow up with anti-schistosomiasis therapy . Results All major lesions were supratentorial and cerebellum was involved in 2 cases as well. The lesion was in a fashion of encephalitis in 4 cases: a hypo-dense patch located in the white matter, in which nodular enhancement was reveal ed after the administration of contrast agent. In 5 cases, lesion was revealed in a granuloma pattern: an iso-dense area located in hypo-dense region, which m anifested multinodular enhancement after the contrast media was given. Other 2 cases had lesions with mixed manifestations described above. Encephalatrophy was found in another case. Conclusion The CT findings and clinical manifestations of cerebral schistosomiasis were various with different pathological stages: in early stage on CT image the lesion may look like encephalitis, which may be cure d by anti-schistosomiasis therapy; in the advanced stage the lesion manifests i n a granuloma pattern and surgical resection was recommended. CT plays an import ant role in the initial diagnosis and follow up.