关键词: 肝脏, 棘球蚴病, X线计算机, 体层摄影

Abstract: Objective: To explore the value of CT for diagnosing hepatic hydatidosis. Methods: A total of 18 cases with pathologically confirmed hepatic hydatidosis were enrolled, and CT features were retrospectively analyzed with the pathological findings served as gold standard. Results: Of the 18 cases, 14 cases were diagnosed as hepatic hydatidosis by CT preoperatively, with an accuracy rate of 77.8%, while 2 cases were misdiagnosed as hepatic cyst, 1 case as liver carcinoma, and 1 case as hepatic hemangioma. For the 17 cases with cystic echinococcosis, 9 cases were of simple cystic type, lesions on CT imaging were presented as single or multiple low density foci, cyst wall arc or eggshell like calcification; 6 cases had echinococcus hydatid sac in cysts with changes of wheeled or honeycomb, and might presented as mixtures of lesions. CT imaging revealed that cystic wall was thicker and cystic density increased when there was infection. The one case of alveolar echinococcosis was misdiagnosed as liver carcinoma, with a wide range of lesions in liver and spread of lesion to bilateral lung on CT imaging. Two cases with single cyst were misdiagnosed as hepatic cyst because CT showed no cyst wall and without obvious contrast enhancement. Conclusions: CT scan can clearly reveal the location, size, number and type of hepatic echinococcosis, which could provide valuable information for diagnosis. Differential diagnosis should be made between hepatic echinococcosis and hepatic cyst when lesions present as simple cysts on CT imaging. CT findings of alveolar echinococcosis are complicated, and should be differentiated from those of liver cancer.

Key words: Hepatic, Echniococcosis, X-ray computed, Tomography