【摘要】 目的 探讨肝脏人体肝巨片形吸虫病的CT及MRI影像表现特点及其诊断价值。方法 回顾分析经临床确诊26例肝巨片吸虫病患者的临床、病理及影像学表现。26例行CT,9例行MR检查,2例行肝穿刺病理检查。结果 26例CT平扫显示为肝肿大并实质内弥漫斑片状密度减低影,边界欠清,15例病灶相互融合呈簇状和或隧道样病灶,以包膜下肝实质内为主,其中24例CT增强病灶不均匀轻度强化;19例脾脏轻度增大。9例MRI平扫显示为肝脏肿大并实质弥漫性病变,病变呈稍长T₁稍长T₂,DWI上呈稍高或高信号改变;7例增强扫描呈蜂窝状稍强化;5例MRCP显示肝内胆管及胆总管未见扩张或梗阻。2例穿刺病理活检表现为寄生虫性肉芽肿与坏死,周围大量单核细胞和嗜酸性粒细胞浸润。结论 熟悉人体肝巨片吸虫感染在肝脏的CT、MRI表现特点,再与血清学相结合,最有助于早期诊断。更多还原

【Abstract】 Objective To explore the CT and MRI features and its diagnostic values in human hepatic fasciola gigantica.Methods Retrospective pathological and imaging analysis of 26 cases in clinically diagnosed patients of hepatic fasciola gigantica.Of which,26 patients had spiral CT scan,9 patients had undergone MRI scan whereas 2 cases had liver biopsy.Results CT of 24 patients revealed hepatomegaly with diffuse patchy liver parenchymal density,with unclear lesion borders.Enhanced CT of 24 patients showed liver lesions with heterogenous mild enhancement.19 cases showed splenomegaly.MRI of 9 cases showed hepatomegaly.The liver parenchyma emitted diffuse slightly longer T₁ and longer T₂ signals.DWI showed slightly higher or high signal changes.In Enhanced scans（7 cases） slight honeycomb appearance was observed.MRCT（5 cases） detailed no enlargement and obstruction of intrahepatic bile duct and common bile duct.Puncture biopsy（2 cases） revealed parasitic granuloma with necrosis,surrounded by heavy mononuclear and eosinophilic infiltration.Conclusion Multi modular imaging technique with available confirmatory enzyme linked immunoassay is most helpful in early diagnosis of fascioliasis.更多还原