CT、MRI对儿童肝泡状棘球蚴病生长特性的评价

CT and MRI in Growth Feature Evaluation for the Children Hepatic Alveolar Echinococcosis

目的探讨儿童肝泡状棘球蚴病(HAE)生长特点。方法搜集45例确诊为HAE患儿(≤14岁),运用CT、MRI评估儿童HAE病灶的一般特点,进行PNM分型,评价其生长特点。结果肝脏P1病灶占11.1%(5/45),P2病灶占35.5%(16/45),P3病灶占15.6%(7/45),P4病灶占37.8%(17/45),88.9%(40/45)病灶最大直径>5 cm,71.1%(32/45)>10 cm。转移共占62.2%(28/45),单个组织器官转移占20.0%(9/45),多个组织器官转移占42.2%(19/45),P1病灶无转移,P2病灶转移占56.3%(9/16),P3病灶转移占85.7%(6/7),P4病灶转移占76.5%(13/17),直接侵犯邻近组织器官占35.6%(16/45),淋巴结转移33.3%(15/45),肺11.1%(5/45)。结论儿童泡球蚴病灶较巨大(除P1病灶),易直接侵犯邻近组织器官及通过淋巴结转移,以多部位组织器官转移常见,在一定程度上反映了儿童肝泡状棘球蚴病生长特点,对临床综合治疗提供重要的参考依据。

Objective To investigate hepatic alveolar echinococcosis growth characteristics imaging features on CT and MRI in childhood. Methods Analysis of 45 cases of pediatric patients diagnosed with liver alveolar echinococcosis,with PNM classification,the CT and MRI features were analyzed. Results P1 lesions accounted for 11. 1%（ 5/45）,P2 lesions 35. 5%（ 16/45）,P3 lesions 15. 6%（ 7/45）,P4 lesions 37. 8%（ 17/45）. In 88. 9%（ 40/45） the maximum diameter of the lesion were more than 5cm,71. 1%（ 32/45） were more than 10 cm. Metastases accounted for 62. 2%（ 28/45）,single tissue and organ metastases comprised of 20. 0%（ 9/45）,and multiple tissues and organs metastases accounted for 42. 2%（ 19/45）. P1 lesions without metastasis,P2 lesions with metastasis accounted for 56. 3%（ 9/16）,P3 lesions with metastasis accounted for 85. 7%（ 6/7）,P4 lesions with metastasis accounted for 76. 5%（ 13/17）,direct invasion of adjacent tissue and organs accounted for 35. 6%（ 16/45）,lymph node metastasis 33. 3%（ 15/45）,lung metastasis 11. 1%（ 5/45）. Conclusion Children alveolar hydatid lesions（ except P1 lesions） were huge,easy to directly invade neighboring tissues and organs,and through lymph node metastasis,multiple organ metastasis was the main manifestation. To a certain extent the results reflects the children＇s hepatic alveolar echinococcosis growth characteristics,and provide important reference basis for comprehensive clinical treatment.