脑裂头蚴病—8例临床病理分析

Clinicopathological analysis of cerebral spargansis: eight cases report.

目的探讨人脑孟氏迭宫裂头蚴病的临床病理特点。方法分析本室１９８２～１９９７年确诊的８例脑裂头蚴病的病理资料，复习其病史和影像学资料。结果本病的病理特点为：１蚴虫虫体为实体，无体腔，具特征性体壁；２蚴虫虫体内散在分布的同心圆性圆形或椭圆形的石灰小体及单个肌纤维；３脑内有新旧不一的多发性小脓肿。ＣＴ及ＭＲＩ所见类似胶质瘤和炎症灶。７例有密切接触池塘、河水史。结论本病临床诊断较困难，但有其特征性的病理表现可据以确诊，主张ＣＴ立体定向术用于诊断和治疗，饮用生水可能是近年的主要感染途径。

Objective To investigate the clinicopathological characters of cerebral sparganosis. Methods Eight cases of cerebral sparganosis treated at Huashan Hospital between 1982 and 1997 were analyzed retrospectively. The history and radiology data of these patients were reviewed. Results The pathological species included:(1) solid larva, no cystic, with thick integument and the irregular folds of pseudosegmentation, (2) numerous concentric circular round or oval shaped calcospherites and longitudinal strips of smooth muscle distributed in the larva, (3) multiple abscess from new to old throught the brain parenchyma. CT and MRI findings were difficult to differentiate from those of glioma or inflammation. Seven cases had the history of close contacting to pond or river. Conclusions Although the diagnosis of cerebral spargansis is diffcult, some characters of histopathology can be used as evidences for diagnosis. CT guided stereotactic biopsy and operation should be emploied for the diagnosis and therapy. The most possible infection route might be drink unboiled water.