Xiong Ziman, Shen Yaqi, Li Zhen, Hu Xuemei, Hu Daoyu
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China.
Abdom Radiol (NY). 2021 Jun;46(6):2584-2594. doi: 10.1007/s00261-021-02952-w. Epub 2021 Jan 23.
To summarize the clinical and radiological features of hepatic trichinellosis.
Patients diagnosed with trichinellosis and liver involvement in our institution since 2011 were included retrospectively. Then, qualified patients were divided into a seropositive group and a clinically diagnosed group. Preoperative liver CT and/or MRI images were evaluated independently by two radiologists. The correlations between the radiological and pathological features were evaluated by a radiologist and a pathologist. Independent t-tests were carried out to assess clinical data between groups and those reported in the previous literature. Values of P less than 0.05 were considered statistically significant.
Eventually, ten patients were enrolled, five in each group. All patients recovered successfully after surgical (n = 8) or conservative treatment (n = 2). The clinical, radiological, and pathological features were highly consistent between the two groups. All patients were under 60 years of age (48.0 ± 7.9 years in the seropositive group, 48.6 ± 10.1 years in the clinically diagnosed group), and they were older than those previously reported in the literature (30.5 ± 17 years, n = 31; P = 0.032 and 0.028). Eosinophilia was found in four patients, and all were mildly increased (˂ 1.5 × 10/L). Lesions in all patients were in the right lobe of the liver, and nine of them showed a characteristic 'curved tunnel' sign on DCE-MRI images. None of the patients had signs or evidence of extrahepatic infection.
The 'curved tunnel' sign on MRI is a typical radiological feature in hepatic trichinellosis.
总结肝旋毛虫病的临床及影像学特征。
回顾性纳入自2011年起在我院诊断为旋毛虫病且有肝脏受累的患者。然后,将符合条件的患者分为血清学阳性组和临床诊断组。两位放射科医生独立评估术前肝脏CT和/或MRI图像。一位放射科医生和一位病理科医生评估影像学和病理特征之间的相关性。进行独立t检验以评估组间临床数据以及与先前文献报道的数据。P值小于0.05被认为具有统计学意义。
最终纳入10例患者,每组5例。所有患者经手术治疗(n = 8)或保守治疗(n = 2)后均成功康复。两组的临床、影像学和病理特征高度一致。所有患者年龄均小于60岁(血清学阳性组为48.0±7.9岁,临床诊断组为48.6±10.1岁),且他们比先前文献报道的患者年龄更大(30.5±17岁,n = 31;P = 0.032和0.028)。4例患者发现嗜酸性粒细胞增多,且均轻度升高(<1.5×10/L)。所有患者的病变均位于肝脏右叶,其中9例在DCE-MRI图像上表现出特征性的“弯曲隧道”征。所有患者均无肝外感染的体征或证据。
MRI上的“弯曲隧道”征是肝旋毛虫病典型的影像学特征。