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目的进一步探讨脑血吸虫病的临床CT表现,提高诊断水平。方法回顾分析经手术病理或临床抗血吸虫治疗随访证实的12例脑血吸虫病人的CT平扫和增强扫描影像资料。结果12例均位于幕上,其中2例同时累及小脑;12例中脑炎型4例,肉芽肿型5例,混合型2例,脑萎缩型1例。脑炎型CT平扫表现为白质低密度,增强后低密度区内斑点及结节状强化;肉芽肿型CT平扫为低密度区内等密度影,增强示多个小结节融合成块状强化。结论脑血吸虫病病理类型不同临床及CT表现各异,早期以脑炎型为主,抗血吸虫治疗可以治愈,晚期形成较大的血吸虫肉芽肿,需手术治疗。CT早期诊断及随访复查极为重要。
Objective To further explore the clinical manifestations of cerebral schistosomiasis and improve the diagnostic level. Methods Retrospective analysis of 12 cases of cerebral schistosomiasis confirmed by pathology or clinical anti-schistosomiasis follow-up CT scan and enhanced scan imaging data. Results All the 12 cases were located on the screen, of which 2 cases involved cerebellum at the same time. There were 4 cases of mesencephalitis in 12 cases, 5 cases of granuloma in 2 cases, 1 case of mixed type and 1 case of brain atrophy. Encephalitis type CT scan showed white matter low density, enhanced low density area spots and nodular enhancement; granulomatous CT scan for the isodense density of low density area, enhanced to show a number of small nodules fusion block Strengthen the shape. Conclusions The pathological types of cerebral schistosomiasis are different in clinical manifestations and CT manifestations. Encephalitis type is predominant in early stage, and anti-schistosome treatment can be cured. Larger schistosomal granuloma is formed in the late stage, requiring surgical treatment. CT early diagnosis and follow-up review is extremely important.