Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
AJR Am J Roentgenol. 2012 May;198(5):1076-83. doi: 10.2214/AJR.11.7530.
The purpose of this study was to characterize the chest CT findings of North American paragonimiasis due to Paragonimus kellicotti in the largest (to our knowledge) case series reported to date and to compare the findings with those reported for paragonimiasis infections in other regions.
A retrospective review was performed of chest CT examinations of eight patients with North American paragonimiasis treated at our institution between 2006 and 2010. Findings were characterized by site of involvement, including lungs and pleura, heart and pericardium, lymph nodes, and upper abdomen.
The most common chest CT findings in this case series were pleural effusions and internal mammary and cardiophrenic lymphadenopathy. Pulmonary parenchymal findings included peripheral lung nodules of 1-3.5 cm in size with surrounding ground-glass opacity; many nodules had a linear track to the pleural surface that may correspond to the worm's burrow tunnel. Pericardial involvement (5/8 patients) and omental inflammation (5/7 patients), which are uncommon in Asian paragonimiasis, were common in this series.
Pleural and pulmonary features of North American paragonimiasis are generally similar to those reported from Asia. The presence of a track between a pulmonary nodule and the pleura may help distinguish paragonimiasis from mimickers, including chronic eosinophilic pneumonia, tuberculosis, fungal infection, or malignancy. Pericarditis, lymphadenopathy, and omental inflammation were more common in our series than in reports on paragonimiasis from other regions. These differences may be related to the infecting parasite species or to the fact that radiologic examinations in the present series were performed relatively early in the course of infection.
本研究旨在描述迄今为止报道的最大的（据我们所知）北美并殖吸虫病的胸部 CT 表现，并将其与其他地区报道的并殖吸虫病感染的发现进行比较。
回顾性分析了 2006 年至 2010 年在我院治疗的 8 例北美并殖吸虫病患者的胸部 CT 检查结果。通过受累部位，包括肺和胸膜、心脏和心包、淋巴结和上腹部，对结果进行了描述。
在该病例系列中，最常见的胸部 CT 发现是胸腔积液和内乳和心膈角淋巴结肿大。肺部实质病变包括大小为 1-3.5cm 的周围肺结节，周围有磨玻璃样混浊；许多结节与胸膜表面之间有线性轨迹，可能与蠕虫的隧道相吻合。心包受累（5/8 例）和大网膜炎（5/7 例），在亚洲并殖吸虫病中并不常见，但在本系列中很常见。
北美并殖吸虫病的胸膜和肺部特征通常与亚洲报道的相似。肺部结节与胸膜之间的轨迹可能有助于将并殖吸虫病与模拟物（包括慢性嗜酸性粒细胞性肺炎、结核、真菌感染或恶性肿瘤）区分开来。心包炎、淋巴结病和大网膜炎在我们的系列中比在其他地区的并殖吸虫病报告中更为常见。这些差异可能与感染的寄生虫种类有关，也可能与本系列中放射学检查是在感染过程的早期进行的有关。
