肝泡状棘球黝病患者磁共振成像影像特征与临床分期的相关性分析

Correlation Analysis of MR Imaging Features and Clinical Stages in Patients with Hepatic Alveolar Echinococcosis

【目的】探讨肝泡状棘球坳病患者磁共振成像影像特征与临床分期的相关关性,以期为肝泡状棘球坳病的早期诊断、治疗和改善患者预后提供理论依据。【方法】回顾性分析2010年1月至2018年1月于本院消化内科接受治疗的74例肝泡状棘球坳病患者的影像学资料,所有患者均接受磁共振成像扫描,分析并对比患者的磁共振成像影像学特点。根据Kodama分型原则对患者的肝泡状棘球黝病灶进行分型,共分为KodamaⅠ〜Ⅴ型,利用Spearman相关性分析模型观察患者肝泡状棘球坳病灶Kodama分型与肝泡状棘球黝病灶最大直径之间的相关性,同时观察PNM不同分期分别与肝泡状棘球坳病灶最大直径之间的相关性。【结果】74例泡状棘球黝病患者共发现泡状棘球坳病灶98个,病灶直径1.25~26.52 cm。所有泡状棘球坳病病灶中P1期34个,P2期7个,P3期53个,P4期4个,M0期82个,M1期16个,N0期53个,N1期45个;泡状棘球坳病患者病灶Kodama分型中以KodamaⅢ、Ⅳ型居多,KodamaⅠ、Ⅱ、Ⅴ型相对较少。Spearman相关性分析显示,肝泡状棘球黝病灶最大直径与P分期呈显著正相关性(r=0.518,P<0.05);肝泡状棘球坳病灶最大直径与N分期呈显著正相关性(r=0.755,P<0.05);肝泡状棘球坳病灶最大直径与M分期无相关性(r=0.216,P>0.05);肝泡状棘球坳病灶Kodama分型与病灶最大直径间无相关性(r=0.214,P>0.05)。【结论】泡状棘球黝病病灶Kodama分型中KodamaⅢ、Ⅳ型居多;PNM分期中P1期、P3期、M0期、NO期居多;肝泡状棘球坳病灶的最大直径与P分期、N分期呈现显著正相关性。

【Objective】To investigate the relationship between magnetic resonance imaging and clinical stage in patients with hepatic alveolar hydatidosis(hepatic echinococcosis),in order to provide a theoretical basis for early diagnosis,treatment and improvement of prognosis of hepatic alveolar echinococcosis.【Methods】The imaging data of 74 patients with hepatic alveolar echinococcosis treated in the Department of Gastroenterology of our hospital from January 2010 to January 2018 were analyzed retrospectively.All patients received MRI scanning,and the MRI characteristics of the patients were analyzed and compared.According to Kodama classification principle,the lesions of hepatic alveolar echinococcus were divided into Kodama Ⅰ〜Ⅴ types.The correlation between Kodama classification and the largest diameter of hepatic alveolar echinococcus was observed by Spearman correlation analysis model,and the correlation between different stages of PNM and the largest diameter of hepatic alveolar echinococcus was observed.【Results】A total of 98 lesions with a diameter of 1.25〜26.52 cm were found in 74 patients.34 lesions in P1,7 in P2,53 in P3,4 in P4,82 in M0,16 in M1,53 in N0 and 45 in N1;Kodama Ⅲ and Ⅳ are the most common types in the lesions of echinococcosis,while KodamaⅠ,Ⅱ and Ⅴ were relatively few.Spearman's correlation analysis showed that there was a significant positive correlation between the maximum diameter of hepatic alveolar echinococcus and P stage(r=0.518,P<0.05);there was a significant positive correlation between the maximum diameter of hepatic alveolar hydatid focus and N stage(r=0.755,P<0.05);there was no correlation between the maximum diameter of hepatic alveolar hydatid focus and M stage(r=0.216,P>0.05);there was no correlation between the Kodama classification and the maximum diameter of hepatic alveolar hydatid focus(r=0.214,P>0.05).【Conclusion】Kodama Ⅲ and Ⅳ were the most common types in Kodama,P1,P3,M0 and N0 are the most common types in PNM,and there was a significant positive correlation between the maximum diameter of hepatic Echinococcus and P and N stages.