慢性血吸虫肝病及并发症的CT表现

目的 分析慢性血吸虫肝病的CT特征,以提高CT对该病诊断的准确性.方法 分析125例临床病理确诊的慢性血吸虫肝病和50例正常对照组的CT特征,并对其各肝叶径线及脾指数进行测量对比.结果(1)血吸虫性钙化:125例中,120例肝脏有不同程度的钙化:肝内及肝包膜下线条样钙化76例,肝内地图样和网格样钙化44例,肝内门脉系统钙化33例;脾脏钙化15例,肠壁钙化85例;(2)肝脾形态改变:肝尾状叶、肝左叶增大,且肝尾状/肝右叶比值亦较正常组大,肝右叶缩小,差异有统计学意义(P<0.01),胆囊窝增大82例,脾指数与正常组无统计学差异(P>0.05);(3)血吸虫肝病合并症:胆囊炎和胆囊结石58例,肝癌11例,肠癌5例,膀胱癌3例.结论 肝内钙化和肝左叶及尾叶增大为慢性血吸虫肝病CT征象,常合并许多并发症.

CT Findings of Chronic Hepatic Schistosomiasis and Its Complications

Objective To analyze the CT characteristics of chronic schistosomiasis liver disease,in order to improve the accuracy of CT diagnosis for the disease.Methods We analyzed the CT features of 125 cases of clinical pathology diagnosis of chronic schistosomiasis liver and of 50 normal control group,and measured the hepatic lobe lines and spleen index.Results(1) Schistosoma calcification:In 125 cases,there were 120 patients with varying degrees of liver calcification, in which 76 cases of intrahepatic or subcapsularlinear calcification,44 cases of reticular or map-like calcification,33 cases of calcification portal system,15 cases of spleen calcification,85 cases of intestinal wall calcification;(2) Morphological changes of the liver and spleen:The transverse diameter of the left hepatic lobe,caudate lobe,and caudate lobe-right lobe ratio were larger in patients with chronic schistosomiasis than controls,the transverse diameter of the right hepatic lobe were smaller and there were statistically difference(P<0.001).There were 82 cases of expanded gallbladder fossa in chronic schistosomiasis.Splenic index in patients with chronic schistosomiasis and had no obvious difference in the control group(P>0.05);(3) Schistosomiasis liver's complications:there were 43 cases of cholecystitis and cholelithiasis,11 cases of liver cancer,5 cases of colon cancer,3 cases of bladder cancer.Conclusion Intrahepatic calcification and the left hepatic lobe and caudate lobe enlargement are CT signs of chronic schistosomiasis,which is often merged with many complications.