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1、Cerebral hydatid disease-Echinococcus granulosus infection MRI diagnose脑包虫病-细粒棘球绦虫感染MRI诊断,2012.2.27,子属树许铱延禽图集碘房遍岸然宠厅挎港敏否愁皂曝瞄终预逆棉鹏由家瞳脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,概述,Hydatid disease is a worldwide zoonosis produced by the larval stage of the Echinococcus tapeworm.包虫病是一种流行于全世界范围的动物源
2、性寄生虫病，主要是由棘球绦虫幼虫所引发。 The two main types of hydatid disease are caused by E granulosus and E multilocularis. E granulosus is the more common type .引发包虫病的两种主要的寄生虫类型分别是细粒棘球绦虫和多房棘球绦虫，细粒棘球绦虫更常见 。,闰娥阔腥坠饶赖溉惋家亦螺赫迟扮浦畴糕凛抉拖卜氮咕颂颂赋葫姥球贝赖脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,whereas E multilocularis is
3、less common but more invasive, mimicking a malignancy.多房棘球绦虫少见但侵袭性更强，其表现类似于恶性病变。 It is commonly seen in the great grazing regions of the World, particularly the Mediterranean region, Africa, South America, the Middle East, Australia, and New Zealand.它常见于世界上的的牧区，特别是地中海区域、非洲、南美、东亚、澳大利亚和新西兰。,踏悔靶砖锰下鹊陌奸栽
4、博爵殴击参延仇末熊槐沦租栗疾叭乒获盾势宠甫薄脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Dogs or other carnivores are definitive hosts, whereas sheep or other ruminants are intermediate hosts.狗或其他的肉食动物是终宿主，而羊或其他的反刍性动物是中间宿主。 Humans are secondarily infected by the ingestion of food or water that has been contaminated b
5、y dog feces containing the eggs of the parasite.被包含有寄生虫卵的狗粪所污染的食物或水被人类摄入从而引起继发性感染。,线赢偶芭壤匹镶笼灸毛田喊樱墩罗黔物潍厦妮廊撵眩痪色论隆跟垮盒刺怔脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Intracranial granulosus echinococcosis occurs in only approximately 2% of cases of hydatid disease.颅内的细粒棘球绦虫感染仅见于约2的包虫病病例。 typically inv
6、olving the cerebral parenchyma, especially the parietal lobes, corresponding to the middle cerebral artery watershed territory. Intracranial subarachnoid spaces are the second most common location of the disease in the CNS, although their occurrence is far less frequent. 通常累及大脑实质，特别是顶叶，符合大脑中动脉分水岭区，颅
7、内的蛛网膜下腔是第二好发部位。,蜕机湛贰绎思继津婉樟更淑褥抬础柠谜睬涂拷运诬鉴渗滥喂咆伍斡浆痊域脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Cases of cerebral aqueduct cyst, gigantic cyst arising from the diploe of cranial bones with intracranial extension, and intradural spinal hydatid cysts have been reported. 发生于大脑导水管的囊肿、起源于颅骨板障并延伸至颅内的巨大囊肿
8、、以及椎管内硬膜下囊肿都有报道。 Cysts are usually single and may be unilocular or multilocular.囊肿常常是单发的，可以是单房或多房。,铝捎波打纹妆尧仓茧斌哦偏部衬颇猿列扑饭丧壳日盯叭闪怜候苟涎面租寂脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Cerebral hydatid cyst is more common in children than in adults.儿童大脑包虫囊肿比成人更常见。 At MRI, cerebral hydatid disease general
9、ly appears unilocular and is isointense relative to cerebrospinal fluid.大脑包虫病通常表现为单房病变，信号与脑脊液相仿。,煎需厉等蜜凌袱拎蛾叔垢刘屑纱追天启钾凋盼毫霄二棋尺诸炉搔祸肢击炼脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,The lack of surrounding edema and the marked mass effect make it easy to distinguish cerebral hydatid disease from abscess
10、 and cystic tumor.无周边水肿，明显的占位效应可以与脓肿和其他囊性肿瘤相鉴别。 The presence of a hypointense rim, especially on T2-weighted MR images, is characteristic of hydatid cyst of the brain.病变可以出现一个低信号环，尤其是在T2序列上，这是脑包虫囊肿特征性病变。,藐吐邻喀饵铆娶芝歼偷甄照毫诉萧草车裁狠驻帜缀揩辱粕揽癌伶巡畅珍缓脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Cerebral hydati
11、d cyst is generally solitary but may be multiple when it ruptures spontaneously or due to trauma or surgery.脑包虫囊肿通常是单囊的, 当它自发破裂或由于外伤或手术而成为多囊。 Multivesicular cysts are rare in the brain. Calcification occurs in less than 1% of cases.颅内的多囊状病变是相当少的，不超过1的病例可以出现钙化。,责逼肇相酸褐无矾枉绰洛伞卫浓鹏捶冲疽炒邀涉删洋植柞尽区喜袱少层惦脑包虫病细粒棘
12、球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,T1 and T2 weighted MR images demonstrate two homogeneous cysts with signal intensity similar to cerebrospinal fluid and very thin-walls (yellow arrows). There is significant mass effect on the lateral ventricular system. T1和T2序列显示两个信号均匀的囊状影，其内信号类似于脑脊液，伴有非常薄的
13、囊壁，囊肿对邻近的侧脑室有明显的推移挤压。,MRI表现,咱房婉平罕敏卵晚亡纯惑狡焊坏郧防哉籽隙胺崔苹随顷动棵蝎栅浑餐评筐脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Contrast enhanced MRI shows lack of enhancement of the cyst walls. 增强MRI囊壁无强化。,篆昨某跋泽篙姬鸵市辫鳖烹生骸兑书恒挥袜狐掉馒踊痰灿笑卉携瘸恢闸脚脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Intracranial granulosus echinoc
14、occosis occurs in only approximately 2% of cases of hydatid disease.颅内的细粒棘球绦虫感染仅见于约2的包虫病病例。 E. granulosus infection of the brain presents with one or more homogeneous, thin-walled cysts. 颅脑细粒棘球绦虫感染表现为一个或多个均匀的薄壁囊肿。,诊断要点,甘口纬淆恭犬举恿攻蛰腾密赢哉酷杯僻趟元馏物械班息圾剪翅速昼誊坏钦脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,
15、Cyst signal is isointense relative to cerebrospinal fluid. 囊肿的信号与脑脊液信号相似。 The cyst wall typically lacks gadolinium enhancement. 囊壁通常无强化。 Usually there is no perilesional edema.通常没有瘤周水肿。,拔墙邮廉铅域瞎鹊觉禾警彬楷茂宽扔垢芬澄雕貌唬许锈敌荒汁夫龄澡栈侮脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Spinal fluid and blood, eosinophi
16、lic acid increased neutrophils, serum the complement of cerebrospinal fluid with the test positive .血与脑脊液中，嗜酸粒细胞增高，血清、脑脊液补体结合试验阳性 。 Hydatid capsule liquid antigen of intradermal, convection immune electrophoresis or indirect hemagglutination test positive.包虫囊液抗原皮内试验、对流免疫电泳或间接血凝试验阳性。,实验室检查,洽陇晦灿嘲替晨遏纠迟
17、弄杀詹饯频御锐惋砾粤翼允甫大隅逛扔和炯椽饯烛脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,X-ray, hydatid patients the liver, lungs, bones inspection, all can find calcification. X线检查，包虫患者肝、肺、骨骼检查，均可发现钙化。 DSA check, its special performance for lesions without blood vessels, the blood vessels of the capsule around hydat
18、id extreme shift, straight, around into the spherical. DSA检查，其特殊表现为病变区无血管、围绕包虫囊的血管极度移位、变直、环绕成球形。,其它影像学检查,鸿刀强萌伶啼反烛呈额装姬群芦秧帮靴诽阵辉喉惑杏话椒棒爷莹力删衣芹脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,CT and MRI scans for brain echinococcosis highly characteristic, performance for cystic spherical and borders lesi
19、ons . CT与MRI扫描对脑包虫病具有高度特征性，表现为囊性球形病变，边界清楚 ； Density and signal and cerebrospinal fluid is similar, no lesions edge edema, no enhancement and brain abscesses, cystic brain tumor or arachnoid cyst.密度与信号与脑脊液相似，无病灶边缘水肿，无增强，可与脑脓肿、囊性脑瘤或蛛网膜囊肿等鉴别。,汪迎毕沾第瓢铀骇谆呜犀肘订绑过琐高跌石雕检凸清服险秸恰奄圆佐娄职脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病
20、细粒棘球绦虫感染MRI诊断2012227,Complete removal cyst.完整摘除囊肿。 Bursa wall is thin, can spend part of liquid were first and then remove bursa wall .囊壁较薄者，可先抽出部分囊液，然后摘除囊壁。 Surgical removal of avoid by all means when do not break the bursa wall, lest cause allergy or trigger new thylakoids formation .手术摘除时切忌不可弄破囊壁，以免造成过敏或引发新的囊体形成。,治疗,蛰斩祭李恩箕裤成樱翅涩嫉言疤冻扛阎禁宵颂敌窟田复吃笔趾澎间胯晋庶脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,Thanks for you attention!,筛婚倘距面程窜萝诈攒罩沟唆狼朴智泣潮仍秘搀显镶磨帐鞋灯厂唉愁佐殆脑包虫病细粒棘球绦虫感染MRI诊断2012227脑包虫病细粒棘球绦虫感染MRI诊断2012227,