Laopaiboon Vallop, Chamadol Nittaya, Buttham Hataichanok, Sukeepaisarnjareon Wattana
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Med Assoc Thai. 2009 Nov;92(11):1476-84.
To compare the CT findings of liver and splenic abscesses in melioidosis (ML) with non-melioidosis (NML).
CT (computed tomography) images of 47 patients with liver and splenic abscesses were retrospectively reviewed. The 28 patients with ML abscesses and 19 with NML abscesses were recruited into the present study. The sizes, shapes, distributions, margins, enhancement patterns and internal architectures of abscesses on CT images were evaluated and analyzed by Chi-square and Fisher exact tests.
Seven and 6 ML patients had liver and splenic abscesses alone respectively, and 15 patients had combined liver and splenic abscesses. All NML patients had only liver abscesses. For liver abscesses, there were 3 ML and 13 NML patients with abscess size > or = 3 cm. Eleven ML and no NML patients had abscesses < 3 cm (p = 0.00). The abscesses were multiple and discretely distributed in all 11 ML patients, but none in NML patients (p = 0.002). Seven ML and 13 NML patients had moderate to marked peripheral enhancement (95% CI: -0.7, -0.01). All splenic abscesses (21 patients) found that B. pseudomallei was the causative organism. They were mostly smaller than 3 cm in size (85.71%), multiple (95.24%), and had no or minimal enhancement (85.71%).
The CT findings of liver abscesses that can help to differentiate ML from NML include sizes, distributions, and enhancement patterns. The features of ML splenic abscesses in the present study were small, multiple, with no or minimal contrast enhancement.
比较类鼻疽（ML）和非类鼻疽（NML）患者肝脾脓肿的CT表现。
回顾性分析47例肝脾脓肿患者的CT（计算机断层扫描）图像。本研究纳入了28例ML脓肿患者和19例NML脓肿患者。通过卡方检验和Fisher精确检验对CT图像上脓肿的大小、形状、分布、边缘、强化方式及内部结构进行评估和分析。
分别有7例和6例ML患者仅患有肝脓肿和脾脓肿，15例患者同时患有肝脾脓肿。所有NML患者仅患有肝脓肿。对于肝脓肿，脓肿大小≥3 cm的ML患者有3例，NML患者有13例。脓肿大小<3 cm的ML患者有11例，NML患者无（p = 0.00）。所有11例ML患者的脓肿为多发且散在分布，而NML患者无此情况（p = 0.002）。7例ML患者和13例NML患者有中度至明显的周边强化（95%CI：-0.7，-0.01）。所有脾脓肿（21例患者）均发现类鼻疽杆菌为病原体。它们大多大小小于3 cm（85.71%），为多发（95.24%），且无强化或强化轻微（85.71%）。
有助于鉴别ML和NML的肝脓肿CT表现包括大小、分布及强化方式。本研究中ML脾脓肿的特征为脓肿小、多发，无强化或强化轻微。
