Anttila V J, Lamminen A E, Bondestam S, Korhola O, Färkkilä M, Sivonen A, Ruutu T, Ruutu P
Department of Medicine, University of Helsinki, Finland.
Eur J Haematol. 1996 Jan-Feb;56(1-2):82-7. doi: 10.1111/j.1600-0609.1996.tb00300.x.
We conducted a prospective study in order to compare ultrasonography, computed tomography and magnetic resonance imaging in the detection of liver foci in patients with acute leukaemia and clinical suspicion of hepatic candidiasis. 28 adult patients fulfilling set entry criteria after recovery from neutropenia were studied. Lesions in the liver were detected by at least one imaging modality in 21 patients: by ultrasonography in 7 (33% of detected cases), computed tomography in 12 (57%) and by magnetic resonance imaging in 20 patients (95%). Magnetic resonance imaging was significantly more sensitive than ultrasonography (p<0.001) and computed tomography (p<0.02). The difference between computed tomography and ultrasonography was not statistically significant (p=0.1). Invasive procedures performed in 10 patients provided definite proof of candidiasis in 5 patients, and nodes on the liver surface, compatible with yeast infection, were seen during laparoscopy in 3 other patients without proof of fungal infection. We confirm that magnetic resonance imaging is superior to ultrasonography and computed tomography in imaging liver foci in leukaemic patients recovering from neutropenia with persistent non-specific signs of infection or hepatic involvement.
我们进行了一项前瞻性研究，以比较超声检查、计算机断层扫描和磁共振成像在检测急性白血病且临床怀疑有肝念珠菌病患者肝脏病灶中的作用。研究了28例从中性粒细胞减少症恢复后符合既定入选标准的成年患者。21例患者的肝脏病灶通过至少一种成像方式被检测到：7例通过超声检查（占检测病例的33%），12例通过计算机断层扫描（57%），20例通过磁共振成像（95%）。磁共振成像比超声检查（p<0.001）和计算机断层扫描（p<0.02）明显更敏感。计算机断层扫描和超声检查之间的差异无统计学意义（p=0.1）。10例患者进行的侵入性检查在5例患者中提供了念珠菌病的确切证据，另外3例患者在腹腔镜检查时可见肝脏表面与酵母菌感染相符的结节，但无真菌感染的证据。我们证实，对于从中性粒细胞减少症恢复且有持续非特异性感染体征或肝脏受累的白血病患者，磁共振成像在肝脏病灶成像方面优于超声检查和计算机断层扫描。
