脾脏包虫病的影像学表现

目的:提高对脾包虫病影像学表现的认识.方法:回顾性分析8例经手术病理证实的脾包虫病的临床,CT和超声资料,探讨其影像学表现特点及诊断.结果:本组8例脾脏包虫的CT表现为单纯囊肿4例,内囊分离1例,多子囊2例,实质钙化1例,其中6例可见致密清晰的囊壁,囊内为水样低密谋,增强扫描病变区未见增强,4例作了超声检查,其中3例显示双层囊壁,囊内为无回声液性暗区,本组中同时伴有肝包虫病者6例,结论:脾包虫病虽然光见,但其影像学表现有一定特点,在脾脏囊性病变的鉴别诊断中不应忽视.     

肝囊性包虫病的声像图特征分析

本文对276例345个肝包虫囊肿进行超声图像的分型分析。根据包虫病及合并症的超声图像特征,结合包虫开门见山的手术病理结果,划分为六型,即：单纯囊型、多子囊型、感染型、破裂型、钙化型及实变型,这六型代表了囊型包虫病的发发展,转归的不同阶段,超声对包虫囊肿的诊断率高,简便易行,可明确包虫的寄生部位、大小、性状,从而选择最佳手术方案,根据不同阶段囊型包虫病所具有的不同声像特征,可做出正确诊断及相应的病理提示。因此,超声检查方法可作为囊型包虫病的首选检查方法。     

超声及CT对囊性肝包虫病的分型在诊治中的价值探讨

目的探讨超声及CT对囊性肝包虫病的分型及其在临床诊治中的价值。方法回顾性分析我院105例经手术病理或穿刺活检证实的肝包虫囊肿患者的超声和CT图像资料,根据WHO超声分型标准对其进行分型,总结每种分型的超声图像特征;以手术结果为标准,比较超声和CT测得的包虫囊肿最大径。结果肝包虫囊肿CE1型9例,CE2型13例,CE3a型12例,CE3b型24例,CE4型22例,CE5型25例。其中CE1型主要表现为单房的类圆形囊性团块,囊壁增厚,呈"双壁征";CE2型主要表现为多房囊性团块,呈"蜂窝样"或"玫瑰花瓣样";CE3a型主要表现为内、外囊壁分离,呈"水中百合征";CE3b型母囊以实性成分为主,其内可见子囊回声;CE4型主要表现为囊肿实变,内无子囊回声;CE5型主要表现为囊壁钙化。超声和CT测得包虫囊肿最大径分别为(10.50±5.37)cm和(9.90±5.04)cm,与术后标本测值(10.50±5.64)cm比较,差异均无统计学差异。结论超声和CT能通过分型反映不同时期包虫囊肿的病理变化,对囊性肝包虫病的临床诊治具有重要价值。     

肺包虫病的CT诊断

目的：研究肺包虫病的特征性CT表现。材料与方法：搜集32例经CT诊断，手术证实的肺包虫病人的检查资料，并进行回顾性分析。结果：32例肺包虫病的主要CT表现是．肺内单纯型，直径2～8cm单发或多发肺内包虫，边缘清晰、密度均匀．内外囊壁紧贴，厚0．1～0．3cm，增强扫描，囊内未见强化。直径9cm以上单囊单发肺内包虫，内囊壁薄而光滑，外囊壁明显增厚粗糙，与受压肺组织分界不清，厚0．4～2cm。含子囊型．囊肿呈分叶状，内伴有网格样高密度影，形似“蜂房状”或“车轮状”．外壁钙化型，卵园型周围呈“蛋壳状”．肺内复杂型，包虫破入支气管，气体窜入内外囊壁之间包虫囊前方呈现“镰刀征”，气体窜入囊内，囊内形成气液平，内液中夹杂气体影，形同“满天星”。包虫破入胸腔，见胸腔积液，胸膜粘连，包央外壁肥厚，内囊塌陷，显示“水上浮莲征”．结论：CT诊断的准确率为100％．     

B超诊断女性盆腔包虫病21例

本文报告２１例盆腔包虫病声像特征,患者年龄２１～５２岁。生活在牧区１５例,居住城镇６例,均有与犬羊接触史。其中７例曾行肝包虫摘除术。全部病例均经手术证实。受检者常规充盈膀胱在下腹部作多切面超声扫查,观察囊肿与周围脏器组织的关系。作者单位：８３０００１　乌鲁木齐市新疆自治区人民医院Ｂ超室结　　果经超声检查,８例多发型包虫囊肿,６例多子囊型包虫囊肿,５例单发型包虫囊肿,２例合并感染型包虫囊肿。后经手术病理证实,超声符合率９０．４８％,误诊率９．５％,包括各１例单发型和多发型包虫囊肿。讨　　论采用Ｂ超…     

高频超声对腘窝囊肿的诊断

目的：探讨高频超声对腘窝囊肿的诊断价值。方法：回顾性分析48例54个PFC声像图表现，并与手术及病理结果进行对照分析。结果：根据其声像图表现，腘窝囊肿可以分为三型：1．单纯囊肿型16个，独立存在于腘窝软组织间，与关节腔不相通；2．分叶囊肿型27个，囊肿形态欠规则，与关节腔相通；3．囊液混浊型11个，囊内见密集光点回声，与合并感染或非感染有关。结论：高频超声对腘窝囊肿具有特异性诊断价值，且能分型，优于其他影像学检查方法，对临床手术治疗及术后随访具有指导意义。     

囊性肝包虫病202例的声象图特征与手术对照分析

本文研究了超声诊断后手术病理证实的202例囊性肝包虫病283个囊肿的声象图资料并提出分类。作者认为,诸如包虫囊肿的囊壁和囊内的许多声象图结构颇具特征,如囊壁呈双层和母囊内呈大小不等、形状不一的多子囊回声等多种声象图特征是肝包虫病诊断的直接依据。这些特征的敏感性99％,特异性100％,准确性99％。     

高频超声诊断表皮样囊肿的价值

目的探讨高频超声诊断表皮样囊肿的价值。方法回顾性分析63例经手术和病理证实的表皮样囊肿患者的超声表现。结果本组63例患者共计66个病灶,其超声表现可分为3型,分别为均质回声型18个、不均质回声型40个、混合回声型8个。彩色多普勒显示所有病灶内均未见血流信号,4个混合回声型病灶在囊周可见较丰富点、条状血流信号。结论高频超声对诊断表皮样囊肿具有重要价值。     

非寄生虫性肝囊肿伴囊壁广泛钙化的影像学诊断

目的：探讨囊壁广泛钙化的非寄生虫性肝囊肿的影像学表现及诊断。方法：结合文献回顾性分析2例经手术病理证实的囊壁广泛钙化的非寄生虫性肝囊肿的影像学征象。结果：2例影像学表现类似；B超示肝右叶不规则强回声后方伴声影：胸部CR示右上腹部不均质高密度块影；CT示肝右叶类圆形等高密度影伴完整钙化环．无增强效应：MRI示肝右叶类圆形异常信号，T1W1为等信号，T2WI为稍高信号，均伴完整低信号环，增强后病灶无强化。结论：囊壁广泛钙化的非寄生虫性肝囊肿的影像学表现比较特殊；B超是发现病变的首选方法，X线平片能显示肝区高密度钙化．CT、MRI、临床资料三者相结合可以作出定性诊断。[著者文摘]     

高频超声诊断鳃裂囊肿

目的 探讨鳃裂囊肿的高频超声特点及鉴别诊断.方法 回顾性分析经手术及病理证实的14例鳃裂囊肿的高频超声表现.结果 14例鳃裂囊肿中,第一鳃裂7例,第二鳃裂5例,第三鳃裂2例;3例合并瘘管.囊肿均边界清晰,呈椭圆形或类圆形.超声表现分为3型:无回声或伴稀疏点状回声型4例;均匀或不均匀低回声内部密集回声型9例;混合回声型1例.6例后方回声增强.3例囊壁和1例囊壁及囊内结节可见彩色血流信号.超声诊断符合率为57.14％ (8/14).结论 鳃裂囊肿有经典发生部位,超声表现多样,需与颈部其他囊性肿物相鉴别.     

儿童肝包虫病的CT特点

目的 探讨儿童肝包虫病的CT表现。方法 回顾性分析27例经病理和/或血清学证实的肝包虫病患儿的临床和CT资料。结果 27例肝包虫病中,肝囊型包虫病26例,肝泡型包虫病1例;单纯肝包虫病10例,合并其他器官包虫病17例;肝内单发包虫18例,多发包虫9例。共发现囊型病灶47个,其中单囊型囊肿占51.06%（24/47）,内囊塌陷型囊肿占42.55%（20/47）,钙化型囊肿占4.26%（2/47）,多子囊型囊肿占2.13%（1/47）,未见实变型囊肿;泡型病灶1个。74.47%（35/47）的囊肿直径>5 cm。结论 CT可定性诊断儿童肝包虫病,是可靠的检查方法。     

CT诊断肝脏包虫病的价值及误诊分析

目的：探讨CT检查在肝脏包虫病诊断中的价值,并进行误诊分析。方法：收集经病理证实的18例肝脏包虫病病例,并以术后病理结果为金标准,回顾分析患者的CT影像特点,并评估CT检查诊断肝脏包虫病的价值。结果：18例肝脏包虫病患者中,经CT检查准确诊断者为14例,CT诊断准确率为77.8%,另4例患者分别被误诊为肝囊肿2例,血管瘤1例,肝癌1例。肝细粒棘球蚴病患者为17例,其中单纯囊肿型9例,CT图像上表现为肝内囊性低密度灶,单发或多发,呈圆形或类圆形,其中2例可见囊壁弧形或蛋壳样钙化,长短、厚薄不一;1例囊内钙化,CT图像上表现为类圆形或球形钙化灶;1例为多发钙化,既可见囊壁钙化型,也可见球形钙化灶型;含子囊型6例,表现为囊中囊、轮状或蜂窝状改变;混合型1例,可见钙化型病灶及含子囊型病灶。合并感染后,患者的CT表现为囊内密度增高,囊壁增厚。肝泡状棘球蚴病患者1例,CT平扫表现为密度不均匀,边界模糊的斑片低密度影,并伴肺播散,该例CT表现为肝内病灶范围广泛、两肺多发类似病灶,被误诊为原发性肝癌伴两肺转移。另有2例患者的CT表现为病灶单发囊性病灶,无囊壁,增强CT图像上未见强化,被误诊为肝囊肿;1例患者的CT表现可见球形钙化,被误诊为硬化性血管瘤。结论：CT检查能准确显示肝包虫病的类型、发生部位、范围和程度,但表现为单纯囊肿型时,需要与肝囊肿鉴别;肝泡状棘球蚴病的影像学表现复杂,需与原发性肝癌鉴别。     

Latex agglutination test (LAT) for antigen detection in the cystic fluid for the diagnosis of cystic echinococcosis

Latex agglutination test (LAT) was standardized and evaluated to detect hydatid antigen in fluid samples aspirated from 6 surgically proved human cases of cystic echinococcosis (CE), 4 suspected human cases of CE (2 cases of cysts in the liver which were not confirmed surgically and 2 cases of pelvic cysts later confirmed as abscesses) and 7 cases of hydatid cysts of liver in cattle. Echinococcus granulosus scolices and hook lets were seen in aspirated fluid by microscopy and the characteristic germinal layer of the cyst wall was demonstrated by histopathology in 6 human hydatid cysts operated and removed by surgery. In case of cattle hydatid liver cysts no scolices or hook lets were seen in aspirated fluid as they were sterile cysts but characteristic laminated layer of the cyst wall was demonstrated by histopathology of these cysts. The LAT could detect antigen in fluid samples collected from all 6 human cases of surgically proved CE and 7 cases of hydatid cyst liver in cattle, thus showing sensitivity of 100%. The LAT could detect antigen in fluid samples collected from 2 suspected cases of CE liver in humans, which were not operated. The LAT was found to be specific.No cross reactivity was observed.The results of the study showed that LAT could be employed as a simple and rapid diagnostic procedure, as an alternate to microscopy, to confirm the hydatid etiology of a suspected cyst.     

小儿体部棘球蚴病CT表现

目的探讨小儿体部棘球蚴病的CT表现特点。方法经手术及病理证实的20例小儿体部棘球蚴病,其中单发棘球蚴病7例,多发棘球蚴病13例,共有32个囊肿,包括肝包虫囊肿17个,肺包虫囊肿9个,腹腔包虫囊肿4个,颈部包虫囊肿1个,胸膜包虫囊肿1个。20例患儿全部接受CT扫描,其中14例同时接受增强扫描。结果 20例患儿32个病灶中,21个表现为单纯性囊肿,11个呈囊肿破裂表现,未见钙化和多子囊征象。结论小儿体部棘球蚴病以多发和单纯性囊肿为主,CT表现特点与成人棘球蚴病存在差异。     

Sonographic management of complicated cystic echinococcosis

IntroductionIn this survey we evaluated the usefulness of ultrasonography (US) in the diagnosis, and in the treatment of complicated hydatid cysts.Materials and methodsFrom June 1985 to June 2004, 221 patients with 294 hydatid cysts were examined. Twenty patients (9.0%) presented 22 complicated cysts (7.4%): 9 with infection, 5 ruptured into the bile ducts, 2 bilomas, 2 cysto-pleural fistulas, 2 allergic reactions, 1 rupture into the peritoneum and 1 intrasplenic hematoma. In all cases, US yielded a specific or suspected diagnosis, also in complications affecting non-hepatic sites, confirmed by computed tomography (CT), endoscopic papillotomy or percutaneous US-guided sampling. All patients with complicated cystic echinococcosis were treated with Albendazole 800 mg/day for at least 3 months. In addition to this therapy, 12 underwent US-guided drainage (9 infected cysts, 2 bilomas, 2 cysto-pleural fistulas, 1 intrasplenic hematoma); of these patients 3 subsequently underwent surgery because US-guided treatment was ineffective. Five patients were treated with perendoscopic sphincterotomy for obstruction of the bile passages, while 3 patients received only medical therapy.ResultsMedical, echoguided and surgical treatments led to resolution of the complications and complete remission of the parasitic pathology in 19/20 patients (95%) and in 21/22 cysts (95.4%). There was partial remission in 1 case only. The therapy did not cause major complications and the results were confirmed during follow-up lasting from 5 months to 15 years (mean time 3 years).Discussion and conclusionThis study shows that the incidence of complications of hydatid cysts is low and that correct echographic management allows a rapid diagnosis and optimization of treatment in most cases.     

Ultrasonography of hepatic hydatid cysts: new diagnostic signs

Eighty-five cases of hepatic hydatid cysts were examined by ultrasonography. On the basis of sonographic patterns (as well as clinical symptomatology and surgical, bacteriologic, and pathologic findings), four groups of cysts were identified: uninfected, organizing, suppurative, and degenerated. A specific sign is defined to differentiate hydatid cysts from cystic lesions of other types. Organizing cysts are defined and ways to differentiate them from infected cysts sonographically are discussed. An analysis was made of the echographically detected material between the daughter cysts previously referred to as "matrix." Clues are given to differentiate infected cysts from liver abscesses. A classification correlating the pathology with the life cycle of the parasite in the human body is proposed.     

腹盆腔包虫病的超声诊断及分型的临床价值

目的探讨腹盆腔包虫病的声像图特征及分型。方法分析49例超声诊断并经手术病理证实的腹盆腔包虫病的资料。结果根据腹盆腔包虫病声像图特征分为单纯囊肿型、多子囊型、实变型及混合型均未探及血流信号。结论腹盆腔包虫病的声像图颇具特征性,超声检查对该病有较高的诊断价值。     

Clinicoepidemiological features of echinococcosis in men serving in the navy

AIM: To analyse echinococcosis morbidity and course characteristics in men serving in the Navy. MATERIAL AND METHODS: The results of annual 1983-2006 check-up of Navy men were analysed to estimate echinococcosis morbidity in patients with eosinophilia and tumors including cysts. The diagnosis was made with application of clinical, ultrasound, radionuclide, morphological (including parasitological), biochemical and immunological methods, computed tomography. RESULTS: 14 cases of hydatid echinococcosis were documented. Most of the patients (85.7%) were young (18-22 years of age). The patients were infected before the army in highly endemic regions. Solitary echinococcosis was detected in 8 patients. In multiple echinococcosis 1 patient had 4 cysts, 3 patients--3, 2 patients had 2 cysts. Echinococcosis of stage 1 was diagnosed in 3 patients, stage 2--in 11 patients. All the patients had cysts in the liver. In multiple echinococcosis the cysts occurred more often in the liver, spleen, kidney; they were rare in the lungs, bones, brain. Pain, asthenovegetative, dyspeptic and allergic syndromes were registered in 71.4, 28.6, 14.3 and 7.1 cases, respectively. Eosinophilia was encountered in 42.9% cases. These syndromes were, as a rule, weakly pronounced. Before accurate diagnosis 6 patients for 4-10 months were treated outpatiently for chronic gastroduodenitis, recurrent lumbalgia, biliary dyskinesia and intercostal neuralgia. CONCLUSION: Echinococcosis incidence rate in the Navy men is very low. They are infected before the army. The disease is diagnosed by chance or late, manifests primarily with pain symptoms.     

A hydatid cyst of the thyroid gland

Echinococcosis, although eradicated in many countries, is still widespread in communities in which agriculture is dominant, and cystic hydatidosis is a significant public health problem in regions where echinococcosis is endemic. Hydatid cysts may be found in almost any part of the body, but most often in the liver and lungs. Other organs affected occasionally include the brain, muscle, kidney, bone, heart and pancreas. This report documents a rare case with a cystic nodule in the thyroid detected by ultrasonography. The patient was a 40-year-old woman with an euthyroid multinodular goitre. Ultrasonography revealed a cystic nodule, and the ultrasonic appearance of the cyst liquid showed multiple echoes, suggesting that the nodule could be a hydatid cyst. Bilateral subtotal thyroidectomy was performed. Postoperative examination of the nodule showed it to be a solitary primary thyroid hydatid cyst.