肺棘球蚴病的CT诊断

CT diagnosis of lung cystic echinococcosis with infections

目的分析肺棘球蚴病的CT表现,评价CT检查的价值。方法23例经手术病理证实为肺棘球蚴病的患者均经CT检查,分析CT表现特点,并对照手术病理结果。结果23例均为单发病灶,右肺15例,左肺8例,下肺多于上肺;CT检查大致分为2型:单纯肿块型7例,表现大小不等、外形欠规则的实性肿块,边缘毛糙,可见浅分叶,周围肺野可见少许纤维影,6例病灶内见弧形或斑点状钙化;肿块呈囊腔型16例,表现为肺内含囊腔肿块,囊腔大小不等,可呈偏心改变;病灶呈球形或不规则型,边缘毛糙,欠光整,周围肺野见棘状或片絮状改变,4例因囊膜剥离形成“水蛇征”或“飘带征”;囊肿钙化7例,表现为囊壁呈弧线形钙化,或伴有内容物的斑点状钙化。结论CT检查能准确显示肺棘球蚴病的部位和形态特征,对该病的诊断和治疗有重要意义。

Objective To analyze the CT findings of lung cystic echinococcosis with infections, and to assess the value of CT examination. Methods The CT characters of 23 cases of pathologically proved lung cystic echinococcosis were analyzed and CT findings were compared with pathology. Results All 23 cases of lung cystic echinococcosis appeared as single cystic lesions. Fifteen cases appeared in the fight lung, and the other 8 in the left. The lesions located in lower lobe were more than those in the upper lobe. According to the CT examination, it could be divided into two types： （1） simple lesion （7 cases） appeared as irregular solid mass with different size, crude edge, and lobulation, and with fiber shadows in the lung field around the lesions. In 6 cases, curvilinear or spotty calcification occurred in the lesions. （2） echinococcosis as a bag （ 16 cases） appeared as a mass with cystic changes in lung tissue with different size and off-center cystic cavity. The lesions took the form of bali or irregular shape. The edge was crude. Around the focus, prickle-like or patchy changes were detected. Ruptured lesions showed ＂water snake＂ or ＂flow ribbon＂ signs in 4 cases. In 7 cases, calcification occurred on the cystic wall or extended into the inside contents. Conclusion CT could aeeurately demonstrate the location, appearance, internal structure, and adjacent situation of the cystic echinocoeeesis, providing valuable information for correct diagnosis and treatment.