【摘要】 目的探讨人体肝巨片形吸虫病的影像学表现特点及其诊断价值。方法回顾分析经临床确诊26例肝巨片形吸虫病患者的临床、病理及影像学表现。26例行CT平扫检查,其中24例行CT增强。9例行MRI平扫检查,其中7例行MRI增强。2例行肝穿刺病理学检查。结果 26例CT平扫示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例脾轻度增大。9例MRI平扫示为肝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。结论人体肝巨片形吸虫感染的CT、MRI表现为肝包膜下多发微小脓肿,部分呈簇状或隧道样特点,结合血清学检查,有助于早期诊断。更多还原

【Abstract】 Objective To investigate the imaging features of hepatic fasciola gigantica.Methods CT with（24） and without（2） intravenous contrast,unenhanced MRI（9） and contrast-enhanced MRI（7） of 26 patients with hepatic fasciola gigantica were retrospectively analyzed.Liver biopsy was performed on 2 patients.Results Unenhanced CT demonstrated hepatomegaly with diffuse patchy liver parenchymal density,ill-defined lesion borders in all 26 patients and splenomegaly in 19 patients.All 24 lesions enhanced heterogeneously and slightly on CT.MRI also showed hepatomegaly in all 9 patients with diffuse slightly low T₁,high T₂signal intensities and hyperintensities on diffusion-weighted imaging.On all 7 contrast-enhanced MRI,honeycomb enhancement pattern was observed.MRCP performed on 5 patients did not show any intra-or extrahepatic bile duct dilatation.Core biopsy on 2patients showed necrotic parasitic granulomas surrounded by heavy mononuclear and eosinophilic infiltration.Conclusion The shape of the trematode with multiple subcapsular microabscesses that coalesce to form tunnel-shaped abscesses are key features on CT and MRI.Multi-modality imaging combined with enzyme-linked immunoassay can aid early diagnosis of fascioliasis.更多还原