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肝脏囊型包虫病的弥散成像及囊液分析对照研究

Diffusion imaging of liver cystic echinococcosis and analysis of cyst fluid: a control study
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摘要 目的:通过对一组肝脏包虫囊肿和非寄生虫性囊肿进行弥散成像以及囊液的生化值的分析,帮助鉴别仅凭单纯影像和血清学试验无法作出肯定诊断的包虫囊肿,并进一步分析研究包虫囊肿和非寄生虫性囊肿囊液的代谢物、电解质、葡萄糖和蛋白质浓度存在差异。资料和方法:通过对29例肝脏囊型包虫病患者以及17例肝脏单纯性囊肿患者进行弥散成像,取其中20例肝脏囊性病灶囊液(其中包虫囊肿13例,非寄生虫性囊肿7例)进行电解质、葡萄糖和蛋白质浓度生化测定。结果:肝脏包虫囊肿在b值1 000 mm/s2弥散图像上ADC值低于肝脏单纯性囊肿,差异有统计学意义,13例肝脏包虫囊肿囊液中葡萄糖、钙离子浓度高于非寄生虫性囊肿,两者间差异有统计学意义。结论:通过肝脏弥散成像可以帮助鉴别包虫囊肿和单纯性囊肿,尤其是早期包虫囊肿,包虫囊肿囊液的葡萄糖含量高于单纯性囊肿,而蛋白含量两者无统计学差异,推测葡萄糖作为大分子物质吸附水分子而导致水分子弥散受限。 Objective: To help the diagnosis of liver hydatid cyst, which is difficult to identify by imaging or serological test alone, by diffusion imaging and biochemical analysis in a group of patients with liver hydatid cyst and non-parasitic cysts, and to study the difference of metabolites, enzymes, glucose and protein concentration of the cystic fluid between hy datid cyst and non-parasitic cysts. Materials and Methods: Diffusion imaging was performed in 29 cases of hydatid cysts and 17 cases of simple cysts. Through echoguided method and surgery, we obtained cystic liquid from 13 cases of hydatid cyst and 7 cases of non-parasitic cysts. The cystic liquid was subjected to the following investigations: evaluation of the macroscopic appearance, determination of the concentration of glucose, nitrogen, sodium, potassium, chlorine, calcium, bilirubin, proteins, and parasitological and cytological evaluation of the sediment. Result: ADC value of hydatid cysts was lower than that of simple cysts, with significant difference. Concentration of glucose, calcium and blood urea nitrogen in 13 cases of liver hydatid cyst fluid was higher than non-parasitic cysts, with significant difference. Conclusion: This study indicates that diffu- sion imaging can help to identify liver hydatid cysts and simple cysts, especially early hydatid cysts. Sampling of the liquid of non-neoplastic cysts of the liver can add information for a correct diagnosis of non-parasitic cysts, hydatid cysts and pseudo- cysts. Glucose of hydatid cyst fluid is higher than simple cyst, but not for protein content, suggesting glucose macromolecules absorbing water molecules as a reason of restricted diffusion.
出处 《中国临床医学影像杂志》 CAS 2012年第12期845-848,共4页 Journal of China Clinic Medical Imaging
关键词 棘球蚴病 磁共振成像 超声检查 多普勒 彩色 Echinococcosis, hepatic Magnetic resonance imaging Uhrasonography, Doppler, color
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参考文献7

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