Analysis Of Imaging Classification、PNM Staging And Growth Characteristics Of HAE In Children

Objective : To explore the imaging classification and PNM(parasite lesion, nerghboring organ invasion, metastases) staging of hepatic alveolar echinococcosis(HAE) in children according to the imaging features and to compara the differences in ADC values of the peripheral zone and normal live parenchyma.To study the growth characteristics of HAE in children.Methods:31 padiatric patients with HAE diagnosed from September 2011 to June 2015 were scanned using CT and MRI,and the all patients≤14 years old, course of the disease, clinical manifestations,laboratory tests,results were recored.CT and MR imaging features of HAE including the lacation,number,size,recorded based on invasion and metastases in order to clarify its PNM staging.To measure the ADC values in normal liv, the solid part of lesion and the peripheral zone of lesion.Results:The course of the disease in 31 patients was mean 2.5±1.4 years.Abdominal pain、jaundice and varying degrees of liver function damage were foung in 23 patients. There were 43 hepatic lesions in 31 patients, 2 of whom invaded the whole liver and could not be counted.Three types of the classification included massive type in 20,liquefaction necrosis ytpe in 9 and multiple nodules type in 2. PNM stage of the WHO informal working group on echinococcosis included P4 stage in 15(48.39%);P3 stage in 6(19.3%),P2 stage in 8(25.8%).N1 stage in 8(25.8%).and M1 stage in 13(41.94%).The invations of bile duct in 23 cases(74.19%)、of portal or Hepatic vein in 25(80.65%) of inferior vena cava or neighboring area in 8 were founded.The ADC values of the normal live parenchyma、peripheral zone of lesion and the solid part of lesion were(1.16±0.15)×10-3mm2/s、(0.98±0.17)×10-3mm2/s and(1.45±0.18)×10-3mm2/s, The ADC value of the solid part of the lesion>the normal live parenchyma>peripheral zone of lesion,exhibiting statistical difference(F=34.423,P=0.0001,P<0.001).Conlusion:The mainly of hepar alveolar echinococcosis(HAE) in children is massive type. It has a special image characteristic:The HAE in children grows towards the regions rich of blood vessels invasively, with the features of fast growth, high transfer rate and PNM advanced stage. The peripheral zone of lesion with DWI(b=800s/mm2)showed high signal in children. Functional MRI can reflect the growth characteristics of the lesions.