67例脑型血吸虫病临床分析

Analysis of Clinical Manifestation of Cerebral Schistosomiasis

目的探求脑型血吸虫病的发生情况、CT及MRI的诊断价值、治疗的选择和观察其预后。方法67例患者常规作免疫、病原学检查及头颅CT或MRI,并给予吡喹酮抗病原治疗,治疗后3个月～5年复查和回访。结果67例免疫或病原学检查呈阳性。头颅CT平扫显示单个或多发病灶,增强扫描病灶呈结节状、斑片状或脑回状强化。MRI显示病灶呈片状或结节状长T1长T2信号灶,增强扫描其内可见斑片状、点状强化灶。9例同时作CT与MRI的患者,显示病灶部位及数目基本相同。治疗后30例复查,头颅病灶消失19例,缩小11例。52例复诊或回访,症状消失45例,减轻7例。结论脑型血吸虫病主要发生在青壮年,头颅CT或MRI对脑型血吸虫病定位和定性诊断有很大价值,用吡喹酮治疗,及早治疗预后良好。

Objective To analyze the frequency of occurrence, diagnostic value of CT and MRI, selection of therapeutic methods,and prognosis of cerebral schistosomiasis. Methods Immunological method, etiological examination, CT, and MRI were used in this study, Patients were reexamined at 3 months to 5 years after the treatment, Results Immunological and etiological examination showed that 67 subjects were positive for cerebral schistosomiasis. Cerebral CT scanning showed 1 to multiple lesions. Nodular, plaque-like, or gyms-like appearance was noted in the lesions, The flaky or nodular T1 and T2 signal foci were seen on MRI, Flaky and spotty foci were seen on enhanced MRI. The results of CT and MRI showed that the location and quality of the foci were almost the same in 9 subjects, The focus disappeared in 19 subjects and reduced in 11 subjects on CT re-examination after treatment. Conclusion Cerebral schistosomiasis is frequently occurred in young individuals. CT and MRI are suitable for diagnosis of cerebral schistosomiasis, Chemotherapy is the major method of treatment for cerebral schistosomiasis. Earlier treatment may improve prognosis