CAJ | 학술논문

目的：探讨肝泡型包虫病（alveolar echinococcosis，AE）影像学分型与 PNM 分期、直径的相关性及其病程变化特点。方法回顾性分析87例 AE 患者的 CT 和 MRI 资料，根据影像学表现对病灶分型，同时记录病灶最大直径、钙化及其 PNM 分期情况。比较不同影像学分型在 PNM 分期、病灶最大直径及钙化方面的差异。结果AE 患者87例111个病灶中肿块型占33．3％（37／111），混合型占41．4％（46／111），假囊肿型占25．2％（28／111）。病灶内钙化形态及分布特点：斑点状占49．5％（55／111），地图状占42．3％（47／111），大片状占8．1％（9／111）；假囊肿型与肿块型及混合型在 P、N 分期及发生钙化方面差异有统计学意义（P ＜0．05）；肿块型与混合型在 P、N分期、最大直径以及发生钙化方面差异均无统计学意义（P ＞0．05）；3种影像学分型病灶最大直径差异有统计学意义（P ＜0．05）；病灶钙化分布与最大直径无相关性（r ＝0．035，P ＞0．05）。结论肿块型与混合型病灶是 AE 晚期的主要表现形式，假囊肿型可能是 AE 的一种特殊类型。
목적：탐토간포형포충병（alveolar echinococcosis，AE）영상학분형여 PNM 분기、직경적상관성급기병정변화특점。방법회고성분석87례 AE 환자적 CT 화 MRI 자료，근거영상학표현대병조분형，동시기록병조최대직경、개화급기 PNM 분기정황。비교불동영상학분형재 PNM 분기、병조최대직경급개화방면적차이。결과AE 환자87례111개병조중종괴형점33．3％（37／111），혼합형점41．4％（46／111），가낭종형점25．2％（28／111）。병조내개화형태급분포특점：반점상점49．5％（55／111），지도상점42．3％（47／111），대편상점8．1％（9／111）；가낭종형여종괴형급혼합형재 P、N 분기급발생개화방면차이유통계학의의（P ＜0．05）；종괴형여혼합형재 P、N분기、최대직경이급발생개화방면차이균무통계학의의（P ＞0．05）；3충영상학분형병조최대직경차이유통계학의의（P ＜0．05）；병조개화분포여최대직경무상관성（r ＝0．035，P ＞0．05）。결론종괴형여혼합형병조시 AE 만기적주요표현형식，가낭종형가능시 AE 적일충특수류형。
Objective To analyze the correlation between imaging type and PNM stage (parasite lesion, neighboring organ invasion,metastases)and diameter of alveolar echinococcosis (AE)lesions,and to ex-plore the development features of this disease.Methods 87 patients with alveolar echinococcosis were ex-amined using CT and MRI examination before medical management.Imaging features including the maxi-mum diameter,calcification pattern,and imaging type of lesion were retrospectively assessed.The correla-tion of imaging type with PNM stage,diameter and calcification pattern was analyzed.Results Lesions (n=111)in 87 patients were divided into three types based on imaging characteristics:solid type (33.3%, 37/111,a solid lesion without liquid necrosis or only small patches of necrosis),mixed type (41.4%,46/111,solid component surrounding large and/or irregular liquid necrosis area),and pseudo-cystic type (25.2%,28/111,large cyst without visible solid component).Lesion calcification in the alveolar echino-coccosis was categorized into three patterns:mild calcification (49.5%,55/111,i.e.inconspicuous calcifica-tion or punctuate scattered calcification),moderate calcification (42.3%,47/111,coastline calcification lo-cated at the periphery of the lesion,with or without the central dot-calcification)and abundant calcification (8.1%,9/111,large calcified deposits).Significant differences were found between pseudo-cystic type and other two types in P,N,M stage,maximum diameter and calcification (P < 0.05),but there was no difference between solid type and mixed type in those mentioned aspects (P >0.05).No correlation was observed between calcification patterns and maximum diameter (P >0.05).Conclusion Solid and mixed type lesions showed some similarities during the course of the disease and accounted for the major form of advanced AE.Pseudo-cystic type represented neither earlier nor advanced stage of AE,but a special pres-entation during AE development.