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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。
Objective To investigate the diagnostic value of hepatic hydatid lesions in early clinical diagnosis, especially screening. Methods According to WHO-IWGE classification criteria of hydatid disease and national diagnostic criteria of hydatid disease by the State Health Planning Commission (Ministry of Health), portable color Doppler ultrasound was performed on Tibetan peasants and herdsmen in 24 administrative villages in 6 counties of 6 counties in Linzhi City, Tibet Autonomous Region. Lesions, Analysis of Ultrasonographic Features of Ultrasonography Screening for Hepatic Hydatidosis with Serological Test Results. Results A total of 42 cases of hepatic hydatid disease were diagnosed, and the total number of lesions was 58. According to one or more criteria that met the specificity of sonography, the number of hydatidiform echinococcosis lesions detected by ultrasound was 49 (84.5%), Nine cases (15.5%) were seropositive in the echinococcosis (echocardiographic findings of intrahepatic lesions but no sonographic features and no other identifiable disease diagnoses). The characteristic ultrasonographic features were thickened cyst wall, the appearance of double wall sign and cystic gland were the most frequently occurred, which were 35, 25 and 24 cases respectively, multiple subcapsular sign, internal cyst wall separation sign, intracapsular Solid change was brain furrow sign, thick cyst wall mixed echo and thick cyst wall calcification frequency were 11,3,6,4 and 8 cases; contrast-enhanced ultrasound for the diagnosis of foamy hydatid disease. Conclusion For the early diagnosis of hepatic hydatid disease without obvious symptoms, ultrasonography is the key point in the diagnosis of hepatic hydatid disease, which can reduce the misdiagnosis and improve the diagnostic rate of hepatic hydatid disease.