张雪倩,鲍海华

泡状棘球蚴病(AE)是由多房棘球蚴幼虫期感染引起的一种罕见的恶性寄生虫病[1]。由于频繁的外源性肿瘤样增生和破坏性生长，AE在行为和外观上与恶性肿瘤相似，可导致受累器官浸润、严重疾病甚至死亡[2]。AE是一种广泛、流行于北半球的疾病，包括中欧、土耳其、俄罗斯、日本、阿拉斯加、北美和中国[3]。在98%的病例中，感染主要表现在肝脏，泡状棘球绦虫的幼虫穿过十二指肠肠壁，通过门静脉系统到达肝脏，表现为肿瘤样恶性生长，如果不进行治疗，90%的病例在诊断后10-15年内死亡[4]。它通过外生芽性生长无限扩散，并侵入周围组织，幼虫的外生增殖能力使其能够通过血液在远端组织如骨、脑和肾中产生转移，也有有证据表明，AE可能通过淋巴引流传播[5]。肝泡状棘球蚴病（HAE）的首选治疗方式为手术治疗[2]。通过完全手术切除寄生虫病灶，然后进行两年药物治疗，可以达到泡状棘球蚴病的最终治愈[6]。然而，许多患者就诊时已为疾病晚期，并且主要肝血管的侵袭以及不受控制的出血和肝功能衰竭等迫在眉睫的风险，通常排除部分肝切除术[1]。在这些患者中，需要持续给予药物进行保守治疗，如阿苯达唑、苯并咪唑。目前，影像学在本病的诊断和监测中起着至关重要的作用。

肝泡状棘球蚴病；多模态成像；影像组学

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