Seon Hyun Ju, Kim Yu-Il, Lee Jee Hyeon, Kim Soo Hyun, Kim Yun-Hyeon
From the Departments of *Radiology and †Respiratory Internal Medicine, Chonnam National University Medical School, Gwangju; and ‡Department of Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
J Comput Assist Tomogr. 2015 Nov-Dec;39(6):956-61. doi: 10.1097/RCT.0000000000000310.
The aims of this study were to evaluate the chest computed tomography findings of parasite infestation regardless of pathogen and to compare the differential findings between paragonimiasis and nonparagonimiatic parasite infestation (NPPI).
Between January 2008 and November 2011, 75 patients (46 men; 52.9 ± 14.1 years) with serologically proven parasite infestation and available chest computed tomography images were evaluated. Computed tomography images of 40 patients with paragonimiasis and 35 patients with NPPI (13 with sparganosis, 12 with toxocariasis, 8 with cysticercosis, and 2 with clonorchiasis) were assessed for the presence or absence of pleural abnormalities, consolidation, cavitary lesions, aggregated cysts, worm-migration tracts, and pure ground-glass opacity. Findings associated with consolidation were further assessed for characteristics including size, perilesional ground-glass opacity, presence of perilesional centrilobular nodules, and internal low attenuation, and multisegmentality and bilaterality were assessed for all patients.
In both groups, the most common pleural abnormality was pleural effusion (42.5% in paragonimiasis vs 22.9% in NPPI, P = 0.09), and the most common pulmonary abnormality was consolidation (82.5% vs 80.0%, P = 1.00). Multisegmentality (35% vs 42.9%, P = 0.64) and bilaterality (55.0% vs 60%, P = 0.82) of pleuropulmonary lesions were often observed in both groups. Internal low attenuation, perilesional centrilobular nodules, cavitary lesions, and worm-migration tracts were more frequently found in the paragonimiasis group (P ≤ 0.05).
The presence of internal low attenuation and perilesional centrilobular nodules associated with pulmonary consolidative lesions, along with cavitary lesions and worm-migration tracts, is more frequent in patients with paragonimiasis than in patients with NPPI.
本研究旨在评估寄生虫感染的胸部计算机断层扫描（CT）表现，而不考虑病原体，并比较肺吸虫病与非肺吸虫性寄生虫感染（NPPI）之间的鉴别性表现。
在2008年1月至2011年11月期间，对75例经血清学证实有寄生虫感染且有可用胸部CT图像的患者（46例男性；年龄52.9±14.1岁）进行了评估。对40例肺吸虫病患者和35例NPPI患者（13例裂头蚴病、12例弓蛔虫病、8例囊尾蚴病和2例华支睾吸虫病）的CT图像评估有无胸膜异常、实变、空洞性病变、聚集性囊肿、虫移行轨迹和单纯磨玻璃影。对与实变相关的表现进一步评估其特征，包括大小、病灶周围磨玻璃影、病灶周围小叶中心结节的存在情况以及内部低密度影，并对所有患者评估多节段性和双侧性。
在两组中，最常见的胸膜异常是胸腔积液（肺吸虫病组为42.5%，NPPI组为22.9%，P=0.09），最常见的肺部异常是实变（82.5%对80.0%，P=1.00）。两组中常观察到胸膜肺部病变的多节段性（35%对42.9%，P=0.64）和双侧性（55.0%对60%，P=0.82）。内部低密度影、病灶周围小叶中心结节、空洞性病变和虫移行轨迹在肺吸虫病组中更常见（P≤0.05）。
与肺部实变病变相关的内部低密度影和病灶周围小叶中心结节以及空洞性病变和虫移行轨迹在肺吸虫病患者中比在NPPI患者中更常见。
