肝包虫病超声特征性表现在早期诊断中的应用

发布时间：2018-11-21 20:20

【摘要】：目的探讨肝包虫病灶声像图表现特征在临床早期诊断尤其是筛查中的应用价值。方法采用WHO-IWGE关于包虫病分型标准和国家卫计委(卫生部)关于包虫病诊断标准,对西藏自治区林芝市6县24条行政村藏族农牧人群进行便携式彩超检查肝包虫病灶,分析超声表现声像图特征结合血清学检查结果筛查肝包虫病。结果共诊断为肝包虫病患者42例,病灶数共58个,根据符合声像图特异性表现之一项或多项标准,超声检出包虫阳性病灶数49个(84.5%),疑似包虫病灶(即超声检查发现肝内病灶但无声像图特征性表现,且无法作出其它明确疾病诊断者)中血清学阳性9例(15.5%)。特征性的超声表现中以囊壁均匀性增厚、双层壁征及囊砂征出现频率为最多,分别为35、25和24例次,多子囊征、内层囊壁分离征、囊内实变呈脑回沟征、厚囊壁内混合回声以及厚囊壁的钙化出现频次分别为11、3、6、4和8例次;超声造影对于泡型肝包虫可明确诊断。结论对于临床早期无明显症状的肝包虫病例,超声检查肝包虫病灶重点观测囊壁和声像图特征是诊断的关键,可以减少漏误诊、提高超声对于肝包虫病的诊断率。
[Abstract]:Objective to investigate the value of ultrasonographic features of hepatic hydatid disease in early clinical diagnosis, especially in screening. Methods using WHO-IWGE criteria for classification of hydatidosis and diagnostic criteria for hydatid disease of the State Health and Family Planning Commission (Ministry of Health), the liver hydatid foci were examined by portable color ultrasound in 24 villages of 24 administrative villages in 6 counties of Linzhi City, Tibet Autonomous region. Analysis of ultrasonographic features combined with serological examination to screen hepatic hydatid disease. Results A total of 42 patients with hepatic hydatid disease were diagnosed with 58 lesions. According to one or more criteria of ultrasonic image, 49 (84.5%) hydatid positive lesions were detected by ultrasound. 9 cases (15.5%) were serologically positive in suspected hydatid foci (I. e., those whose liver lesions were found by ultrasound but were characterized by silent images and could not make any other definite diagnosis of the disease). In the characteristic ultrasonography, the thickness of the cystic wall was homogeneously thickened, and the double wall sign and sand sign were the most frequent, which were 35 ~ 25 and 24 times respectively. The multiple capsule sign, the inner wall separation sign, the intracapsular consolidation sign were presented as gyrus sulcus sign. The frequency of mixed echo and calcification of thick cystic wall were 113X 6 times and 8 times respectively. Contrast-enhanced ultrasonography can be used to diagnose hepatic hydatid disease. Conclusion for the cases of liver hydatid disease without obvious symptoms in early stage, the key to diagnosis is to observe the characteristics of cystic wall and sonogram by ultrasonic examination, which can reduce the misdiagnosis of leakage and improve the diagnostic rate of hepatic hydatid disease by ultrasound.
【作者单位】：广州医科大学附属第一医院超声科;广州市第一人民医院超声科;中山大学孙逸仙纪念医院超声科;中山大学附属第一医院超声科;广东省妇幼保健院超声科;中山大学肿瘤防治中心超声科;东莞市第八人民医院超声科;东莞市第三人民医院超声科;中山大学附属第五医院超声科;珠海市人民医院超声科;中山大学附属第三医院超声科;南方医科大学南方医院超声科;
【分类号】：R445.1;R532.32

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