超声诊断华支睾吸虫病的临床价值

目的：探讨B超对诊断华支睾吸虫病的价值．以助于临床诊断。方法：回顾性分析了50例在我院经手术及实验室检查确诊的华支睾吸虫病患的肝脏声像图特点。结果：50例华支睾吸虫病患，肝脏均有特征性声像图改变：肝内网络状强回声改变，肝内小胆管扩张，呈间断小等号状回声。部份患胆总管内可见虫体所致浮动的细管状高回声。结论：华支睾吸虫病有典型的B超图像特征，B超对于诊断华支睾吸虫病及其并发症有重要的临床价值。     

华支睾吸虫病的超声诊断价值

目的 探讨二维超声诊断华支睾吸虫病的声像图表现及其临床应用价值。方法 应用二维超声对308例华支睾吸虫病患者进行检查，观察肝、胆声像图特点，重点观察肝内外胆管有无扩张及其分布、胆管壁回声、肝实质回声、胆囊情况。结果 279例华支睾吸虫病有特征性表现。271例肝内胆管较均匀或节段性扩张，部分被膜下小胆管囊状扩张，胆管壁增厚、回声增强，以Ⅱ、Ⅲ级胆管较为明显；60例胆囊内可见点絮状飘浮物回声。5例肝吸虫致胆道阻塞时可见胆管较均匀扩张，管壁增厚，呈低回声，与周围肝组织分界清晰，管腔内充满不均质回声。本组中经超声诊断华支睾吸虫病的准确率98．9％，敏感性90．3％，特异性100％。结论 华支睾吸虫病的二维超声声像图表现有一定特异性。超声检查是诊断该病的首选方法，有较高的临床应用价值。     

华支睾吸虫病的彩超诊断价值

目的:研究华支睾吸虫病的彩超声像图表现及其诊断价值。方法:对已确诊的250例华支睾吸虫病患者进行肝脏、胆囊及胆管彩超检查,对照组为同期健康体检者250例。结果:病变组225例有肝胆系统超声改变,占被检人数的90%。对照组50例有肝胆系统超声改变,占被检人数的20%。特异性的声像改变为:肝内胆管回声增强、管壁增厚,呈小等号样"="改变。病变组与对照组差异有统计学意义(P<0.05)。结论:彩超检查显示华支睾吸虫病的特征性超声声像图改变,为该病的首选影像检查方法之一。     

华支睾吸虫病声像图分析及评价

目的 探讨华支睾吸虫病超声诊断的价值。方法 通过对华支睾吸虫病声像图对比分析及临床流行病学的方法评价，实验病理对照研究。结果 肝内小胆管广泛均匀的扩张、胆管树比例失调，以及胆囊内所显示的点状、絮状回声，具有特征性。超声诊断华支睾吸虫病的敏感度98．2％，特异度97．6％，准确度97．9％。结论 声像图用于华支睾吸虫病筛查可减少漏诊、误诊，有重要的临床实用价值。     

华支睾吸虫病的声象特征

本文应用B型超声显象检查华支睾吸虫病73例,发现其主要特征为肝内胆管的严重病变与肝、肝外胆     

胆管细胞癌与华支睾吸虫病的相关性研究

目的:探讨胆管细胞癌与华支睾吸虫病的相关性。方法:通过比较胆管细胞癌在感染华支睾吸虫人群与未感染华支睾吸虫人群发病率的差异。结果:感染华支睾吸虫病691人中,胆管细胞癌患者26例,其中男24例,女2例;未感染华支睾吸虫病539人中,胆管细胞癌患者8例,其中男6例,女2例。结论:感染华支睾吸虫病胆管细胞癌发病率高于未感染华支睾吸虫人群组,华支睾吸虫可视为胆管细胞癌的高危因素。     

华支睾吸虫病超声声像图表现及分析

目的探讨超声诊断华支睾吸虫病的声像图表现及其临床应用价值。 方法对已确诊为华支睾吸虫病的56例患者进行超声检查,观察肝、胆、脾声像图特征。 结果54例华支睾吸虫病声像图有特征性表现,占被检人数的96.4%。主要表现为肝内胆管较均匀、轻度扩张,胆管壁增厚、回声增强,以、级胆管较为明显,部分病例出现肝脏、胆囊病变。超声声像图表现与感染程度、患者年龄、病程长短、用药情况密切相关。 结论华支睾吸虫病的超声声像图表现有一定特异性,超声检查具有操作简便,可重复等优点、是诊断该病的首选方法。     

90例华支睾吸虫肝病的B型超声诊断

我们在应用B型超声检查肝胆系疾病时发现,华支睾吸虫病患者的肝脏除具有一般常见的声像图征象外,肝门部结构模糊,胆管系统回声普遍增强,壁增厚这一特异的声像图表现是诊断本病和与其它肝胆疾病鉴别的特异性改变。本文对我院1985年3月～1992年9月期间,感染科门诊、住院患者及寄生虫学教研室普查提供的90例华支睾吸虫病患者     

华支睾吸虫病的CT分析

华支睾吸虫病的ＣＴ分析广东省顺德市桂洲医院（５２８３０５）覃日才，钟颂学，陈健雄，黎宝玲华支睾吸虫病主要在东南亚地区及我国华南等地区流行，广东省珠江三角洲地区是主要流行区之一，其成虫寄生于人类的胆道系统内，华支睾吸虫病与胆道细菌感染，肝内胆管癌的发生...     

42例华支睾吸虫感染者B超声像图所见

华支睾吸虫病在我国分布广且危害性大。如何提高诊断率,是开展防治工作的重要环节。根据华支睾吸虫痫流行分布特点,对湖北省阳新县42例华支睾吸虫病人进行肝脾、胆囊超声检查。 资料和方法 42例受检者中男性20例,女性22例,年龄3～57岁,平均24岁。用改良加藤法做虫卵计数,轻度感染34例,中度5例,重度3例。 采用SSD-26型和EUB-26型怒声显像仪。频率     

华枝睾吸虫病声像图表现探讨

目的观察分析华枝睾吸虫病的声像图改变,以提高对本病超声表现的认识.方法回顾分析了78例华枝睾吸虫病患者的声像图表现特点.结果华枝睾吸虫病患者肝内外胆管、胆囊、肝脏等脏器可出现一系列的超声改变,其中以肝内小胆管的改变较具特征性,表现为等号状或树枝状小胆管扩张,管壁增厚模糊,越靠近肝脏边缘的小胆管改变越明显,尤以肝左叶的病变为重.胆囊和肝实质的超声改变无特异性,需与其它疾病鉴别.结论华枝睾吸虫病的声像图表现具有一定特征,认识这些特征有助于鉴别诊断.     

全肠外营养所致的肝脏损害─附5例报告

以光镜观察了５例胃肠瘘行全肠外营养（ｔｏｔａｌ　ｐａｒｅｎｔｅｒａｌｎｕｔｒｉｔｉｏｎ，ＴＰＮ）支持治疗之肝活检标本。肝之基本病变为淤胆，最先见于胞浆，继而毛细胆管和小胆管；其他病变，如肝细胞变性、枯氏细胞增生、汇管区扩大和纤维及小胆管增生，以及小胆管周围炎等，均为长期淤胆之结果。临床有些酶异常先于病理改变；发病与ＴＰＮ用量、使用时间及营养配方有关。     

原发性胆汁性肝硬化磁共振成像表现与病理分期的相关性研究

目的探讨原发性胆汁性肝硬化(PBC)的MRI表现及其与病理分期的相关性。材料与方法回顾性分析我院确诊的50例PBC患者(观察组)和44例因其他疾病所致肝硬化患者(对照组)的肝脏MRI表现及临床、病理资料。PBC的严重程度根据病理组织学改变分为Ⅰ~Ⅳ期。分析并比较以上两组患者的MRI表现有无差别,探讨不同病理分期PBC的MRI征象异同。结果 PBC常见的MRI表现主要包括T2WI肝实质信号强度不均匀、门静脉周围长T2信号、门静脉周围晕征、肝内胆管数目减少及管径狭小、花边样肝纤维化、节段性肝萎缩或肥大、腹腔淋巴结增大、腹水及脾大。比较PBC与其他原因肝硬化的MRI征象发现,两组间门静脉周围晕征(χ~2=6.887,P0.05)、肝内胆管减少及管径狭小(χ~2=5.537,P0.05)和淋巴结增大(χ~2=22.297,P0.05)的显示率在统计学上有显著性差异。在病理分期不同的PBC患者中,Ⅱ期与Ⅲ期之间门静脉周围晕征(P0.05)和肝内胆管减少及管径狭小(P0.05)的显示率有显著性差异,而淋巴结增大(P0.05)的显示率无显著性差异。结论 PBC的MRI表现与病理分期具有相关性,MRI检查有助于评估PBC病变的严重程度。     

Clinical value of MRC in the follow-up of liver transplant patients with a choledochojejunostomy

BACKGROUND: We investigated the clinical value of magnetic resonance cholangiography (MRC) in liver transplant patients receiving choledochojejunostomy (CDJ). METHODS: Twenty-five MRCs were performed in 23 initially asymptomatic patients 19 months (mean) after liver transplantation with biliary reconstruction via CDJ. The images were evaluated by consensus (two investigators) for bile duct strictures and dilatations. As a standard of reference, clinical follow-up (including laboratory analysis) was used in 20 cases and direct cholangiography or surgery in three cases. RESULTS: Fourteen pathologic findings were observed in 11 patients (anastomotic strictures in four, left or right bile duct strictures in three, and peripheral segmental dilatations with or without strictures in seven). Patients with pathologic MRC findings had significantly higher levels of alkaline phosphatase (p < 0.05) and more frequently had histories of cholangitis than did patients with normal MRC. Four of six patients with stenoses of the central bile ducts subsequently developed biliary complications requiring treatment (three confirmed by direct cholangiography). In patients with unremarkable bile ducts or only peripherally located changes on MRC, no bile duct complications or relevant changes in the cholestasis parameters occurred during follow-up (mean = 30 months). CONCLUSION: MRC can noninvasively detect pathologic biliary tract changes in liver transplant patients in the asymptomatic stage and provide information for planning invasive therapeutic procedures.     

婴儿及少儿型常染色体隐性多囊性肾病的CT与MRI表现

目的 观察婴儿及少儿型常染色体隐性多囊性肾病（ARPKD）的CT、MRI表现。方法 回顾性分析11例婴儿及少儿型ARPKD患者腹部CT及MRI上肝叶比例、双肾体积改变以及胆管与肾脏囊样病灶的表现。结果 11例婴儿及少儿型ARPKD患者中,5例（5/11,45.45%）肝叶比例失调。5例（5/11,45.45%）中央区域肝内胆管以梭形扩张为主、3例（3/11,27.27%）肝边缘部胆管扩张明显、3例（3/11,27.27%）沿门静脉周围可见多发囊样灶。2例（2/11,18.18%）肾脏体积增大。8例（8/11,72.73%）双肾髓质可见多发小囊样灶、3例（3/11,27.27%）双肾皮髓质多发囊肿。8例（8/11,72.73%）门静脉增粗、脾大。2例（2/11,18.18%）腹部可见多发肿大淋巴结。5例（5/11,45.45%）MR平扫T1WI显示双肾皮髓质分界不清。结论 婴儿或少儿型ARPKD以肝胆改变为主,特征性CT及MRI表现为肝叶比例与肾脏体积的改变合并胆管扩张及双肾囊样灶。     

MOBILIZATION OF BASOPHILE SUBSTANCE (RIBONUCLEIC ACID) IN THE CYTOPLASM OF LIVER CELLS WITH THE PRODUCTION OF TUMORS BY BUTTER YELLOW

Butter yellow (dimethylaminoazobenzene) causes degenerative changes in liver cells accompanied by chromatolysis of cytoplasmic structures that stain with basic dyes because they contain ribonucleic acid. These changes are profoundly modified by the protein content of the diet. Chromatolysis is succeeded by focal regeneration with reaccumulation of ribonucleic acid in the cytoplasm of liver cells; these foci of basophile hyperplasia have their origin in the parenchyma surrounding portal spaces and consist of cells arranged in columns or as tubules with lumina. Hepatomas arise from foci of basophile hyperplasia and corresponding with the arrangement of cells in these foci may be trabecular or adenomatous. Butter yellow causes new formation of bile ducts which arise chiefly in the immediate neighborhood of secondary portal spaces and produce the precancerous lesion, designated cholangiofibrosis. These bile ducts may accumulate ribonucleic acid in their cytoplasm and undergo hyperplasia. Cholangiomas arise from newly formed bile ducts that are the site of basophile hyperplasia. Changes accompanying chromatolysis and basophile hyperplasia aid in the definition of structural elements of the cytoplasm and in the localization of ribonucleic acid with relation to the mitochondria.     

华支睾吸虫病126例超声图像分析

目的分析126例华枝睾肝吸虫病患者声像图表现，探讨超声对本病的诊断和鉴别诊断价值。方法对已确诊的126例华枝睾肝吸虫病患者进行肝、胆、脾、胰超声检查，观察其声像图表现。结果华枝睾肝吸虫病声像图上主要表现为肝内小胆管扩张，胆管壁增厚，回声增强，以肝左叶明显。另外可出现胆囊和肝实质改变，并需与其他疾病相鉴别。结论华枝睾肝吸虫病具有特征性的声像图表现，超声检查操作简便，可作为普查手段，对本病做出早期诊断。     

Intraductal mucosal-spreading mucin-producing peripheral cholangiocarcinoma of the liver

The computed tomographic (CT) appearance of a case of intraductal mucosal-spreading mucin-producing peripheral cholangiocarcinoma of the liver is described in a patient presenting with acute pericardial tamponade due to rupture of the cystically dilated left intrahepatic ducts by mucin hypersecretion. CT showed cystic and tubular dilatation of the intrahepatic ducts of the left and caudate lobes, but there was no grossly visible tumor mass. Pathology showed a single layer of tall columnar tumor cells with short intraluminal papillary projections lining each bile duct; the ducts were markedly dilated because of excessive mucin secretion. There was no gross tumor mass in the bile ducts. The tumor spread diffusely and contiguously along the intrahepatic bile ducts, with minimal invasion to the bile duct wall. To our knowledge, there has been no report about mucosal-spreading peripheral cholangiocarcinoma of the liver. Received: 12 November 1998/Revision accepted: 10 March 1999     

经T管超声胆管造影评估肝移植术后早期肝内外胆管

目的 探讨以经T管超声胆管造影(CEUSC)评估肝移植术后早期肝内外胆管的可行性。方法 纳入17例接受肝移植患者,均于术后早期(中位时间28天)因血清学检查异常接受经T管二维、三维CEUSC及X线胆管造影检查;对比3种方法显示肝外胆管(尤其是吻合口区域),左、右叶肝内胆管及其不同级别分支的能力。结果 17例中,3例发生胆道并发症,包括T管脱出2例、胆管结石1例。二维、三维CEUSC均可清晰显示并明确诊断;X线胆管造影仅显示2例T管脱出,未显示胆管结石。除2例因T管脱出未能显示肝内外胆管外,3种检查对其余15例均能完整显示肝外胆管及1、2级肝内胆管,符合诊断要求。3种检查方法所示肝右叶最远端胆管级别均高于肝左叶(P均＜0.05),其间差异无统计学意义(P＞0.05)。3种方法对1~4级肝内胆管评分差异均无统计学意义(P均＞0.05),对5级肝内胆管评分差异有统计学意义(P＜0.01),其中二维CEUSC评分高于X线胆管造影和三维CEUSC (P均＜0.05)、X线胆管造影与三维CEUSC差异无统计学意义(P＞0.05)。结论 经T管CEUSC可于肝移植术后早期显示肝内外胆管,辅助诊断胆道并发症。     

Biliary parasitic diseases including clonorchiasis,opisthorchiasis and fascioliasis

Parasitic infection of the biliary tree is caused by liver flukes, namely Clonorchis sinensis and Opisthorchis viverrini. These flukes reside in the peripheral small bile ducts of the liver and produce chronic inflammation of the bile duct, bile duct dilatation, mechanical obstruction, and bile duct wall thickening. On imaging, peripheral small intrahepatic bile ducts are dilated, but the large bile ducts and extrahepatic bile ducts are not dilated or slightly dilated. There is no visible caused of obstruction. Sometimes, in heavy infection, adult flukes are demonstrated on sonography, CT or MR cholangiography as small intraluminal lesions. The flukes in the gallbladder may appear as floating, small objects on sonography. Chronic infection may result in cholangiocarcinoma of the liver parenchyma or along the bile ducts. Human infection of Fasciola hepatica, a cattle flukes, may occur inadvertently, and the flukes migrate in the liver (hepatic phase) and reside the bile ducts (biliary phase). Image findings in the hepatic phase present with multiple, small, clustered, necrotic cavities or abscesses in the peripheral parts of the liver, showing “tunnels and caves” sign, reflecting parasite migration in the liver parenchyma. In the biliary phase, the flukes are demonstrated in the intra- and extrahepatic bile ducts and the gallbladder as small intraluminal flat objects, sometimes moving spontaneously. Bile ducts are dilated.