[1]冯庆,戴敏,马华怡,等. 恶性血液系统疾病患者肝脏真菌感染的CT表现[J].中国医学物理学杂志,2018,35(5):549-552.[doi:DOI:10.3969/j.issn.1005-202X.2018.05.010]
　FENG Qing,DAI Min,MA Huayi,et al. CT characteristics of hepatic fungal infections in patients with malignant hematological diseases[J].Chinese Journal of Medical Physics,2018,35(5):549-552.[doi:DOI:10.3969/j.issn.1005-202X.2018.05.010]
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 恶性血液系统疾病患者肝脏真菌感染的CT表现()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第5期
页码:
549-552
栏目:
医学影像物理
出版日期:
2018-05-22

文章信息/Info

Title:
 CT characteristics of hepatic fungal infections in patients with malignant hematological diseases
文章编号:
1005-202X（2018）05-0549-04
作者:
 冯庆1; 戴敏2; 马华怡1; 韦怡怡1
 1.柳州市工人医院放射科，广西 柳州 545005；2.南方医科大学南方医院血液科，广东 广州 510515
Author(s):
 FENG Qing1;  DAI Min2;  MA Huayi1;  WEI Yiyi1
 1. Department of Radiology, Liuzhou Workers’ Hospital, Liuzhou 545005, China; 2. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
关键词:
肝脏; 真菌感染; CT; 恶性血液系统疾病
Keywords:
 ; liver;  fungal infection;  computed tomography;  malignant hematological disease
分类号:
R814.42
DOI:
DOI:10.3969/j.issn.1005-202X.2018.05.010
文献标志码:
A
摘要:
 目的：分析恶性血液系统疾病患者肝脏真菌感染的CT表现。 方法：回顾性分析23例确诊肝脏真菌感染患者的临床及影像学资料，所有患者均采用SOMATOM Definition AS 64层螺旋CT机对上腹部进行平扫及三期增强扫描，分析其CT表现。 结果：23例患者中，12例（52.17%）出现肝脏肿大；23例均为多发性病灶，共发现285个病灶；病灶呈圆形或类圆形，直径均小于20 mm；病灶呈散在或弥漫分布，无特殊好发部位；病灶CT表现可以分为5种类型：[①]单纯低密度影，病灶小，平扫及动脉期均为低密度，门脉期及延时期为等密度，该型共2例（8.70%）；[②]环形，平扫为中央低密度影，动脉期周围出现强化环，门脉期及延时期等密度，该型共10例（43.48%）；[③]靶形，平扫病灶为边界较为清晰的低密度影；动脉期中央为小结节状强化，周围低密度环状，外周为一薄厚不均的环状强化带；门脉期及延时期周围低密度环状区域不同程度强化，外周强化带消失，该型共8例（34.78%）；[④]牛眼形，三期均为中央低密度，周边为强化环，该型共1例（4.35%）；[⑤]病灶呈现多个结节融合的不规则肿块，有2个及以上上述类型的病灶聚集在一起，该型共2例（8.70%）。 结论：肝脏真菌感染的CT表现具有一定的特征性，CT检查对于其诊断具有积极意义，值得在临床推广。
Abstract:
 Objective To analyze computed tomography (CT) findings of hepatic fungal infections in patients suffering from malignant hematological diseases. Methods The clinical and imaging data of 23 patients with confirmed hepatic fungal infections were retrospectively analyzed. All patients underwent the plain and three-phase enhanced scans of the upper abdomen with a SOMATOM Definition AS 64-slice CT scanner, and the obtained CT findings were analyzed. Results Of all 23 patients, 12 (52.17%) developed liver enlargement. All patients had multiple lesions, and a total of 285 lesions were found in 23 cases. Lesions were round or round-like, with a diameter less than 20 mm. The lesions distributed in scatter or diffusely, without developing in predilection sites. The focal CT findings were able to be divided into 5 types. (1) Lesions appeared simple low density shadows, and the foci were small. Both plain scan and arterial phase showed low density, but portal phase and delayed phase showed equal density. These CT features were observed in 2 cases (8.70%). (2) A total of 10 patients (43.48%) developed annular lesions. Plain scan showed low density shadows in central region. Peripheral enhancement ring was observed in arterial phase, but portal phase and delayed phase showed equal density. (3) Lesion appeared target shape. Plain scan demonstrated low density shadows with relatively clear boundary. Arterial phase revealed a small nodular enhancement in central region, surrounded by low density ring, with an uneven thickness of annular enhancement zone in peripheral region. The low density annular region around the portal and delayed phases had various enhancements, and the peripheral enhancement zone disappears. There were 8 cases (34.78%) of this type. (4) Only 1 case (4.35%) developed lesions which appeared bullous shape. All the 3 phases showed low density in central region, surrounded by enhancement ring. (5) In the last 2 cases, lesions present as irregular mass of multiple nodular fusions, with two or more types of lesions gathering together. Conclusion CT findings of hepatic fungal infection have certain characteristics. Therefore, CT examination has a positive meaning for the diagnosis of hepatic fungal infection, worthy of clinical promotion.

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备注/Memo

备注/Memo:
 【收稿日期】2018-02-21
【基金项目】国家自然科学基金（81470349）
【作者简介】冯庆，主治医师，研究方向：肝脏真菌感染的影像表现，E-mail: 245268195@qq.com
更新日期/Last Update: 2018-05-22