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目的回顾分析慢性血吸虫病腹部CT表现与病理结果,以求进一步提高对其的诊断准确性。方法103例患者进行腹部CT平扫,81例行CT增强扫描;全部病例均获得手术标本及作病理切片,并注意切片方向与CT扫描层面相近的平面进行。结果CT显示肝硬化84例,以肝脏右叶改变最重;肝内不同形态钙化71例,以分隔状钙化最多;肝癌12例;脾脏增大78例,脾脏钙化13例;结肠壁增厚27例,以降、乙状结肠及直肠增厚居多;结肠壁钙化31例,其中全结肠弥漫性钙化5例;结肠癌9例。病理观察肝内不同程度纤维化并形成假小叶,纤维增生间隔及假小叶内均可见虫卵及钙化;结肠黏膜下及区域淋巴结内可见虫卵及钙化。结肠壁纤维组织及黏膜组织增生明显;脾内可见纤维增生及钙化,但未见虫卵。结论慢性血吸虫病对腹部脏器的损伤以肝脏及结肠为重,CT的病理性改变也相对明显,而脾脏改变大多是肝硬化的伴随变化。CT腹部扫描检查是慢性血吸虫病脏器病理损害和程度的重要影像诊断方法。
Objective To retrospectively analyze the CT findings and pathological findings of chronic schistosomiasis in order to further improve its diagnostic accuracy. Methods Totally 103 patients underwent CT scan of abdomen and 81 patients underwent enhanced CT scan. Surgical specimens and biopsy specimens were obtained in all cases. Note that the slice direction was similar to that of CT scan. Results CT showed that cirrhosis in 84 cases, the most obvious change in the right lobe of the liver; intrahepatic calcification in 71 cases of different forms to the most calcified calcification; liver cancer in 12 cases; spleen increased 78 cases of splenic calcification in 13 cases; colon wall thickening 27 Cases, to drop, the majority of sigmoid colon and rectum thickening; colon wall calcification in 31 cases, including diffuse calcification in 5 cases of colon; colon cancer in 9 cases. Pathological observation of varying degrees of intrahepatic fibrosis and the formation of false lobules, fibrous proliferative interval and pseudolobule were visible eggs and calcification; colon mucosa and regional lymph nodes can be found in eggs and calcification. Colon wall fibrous tissue and mucosal tissue hyperplasia; spleen fiber proliferation and calcification, but no eggs. Conclusion Chronic schistosomiasis has the most severe injury to the liver and colon in the abdominal organs. The pathological changes of CT are relatively obvious. The changes of the spleen are mostly accompanied by changes of the liver cirrhosis. CT abdominal scan examination is an important imaging diagnosis of chronic schistosomiasis pathological damage and extent.