华支睾吸虫病超声诊断价值.docVIP

华支睾吸虫病超声诊断价值 　 作者：李建辉 李泉水 何慧明 陈毓菁 【摘要】 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。 【关键词】 华支睾吸虫病 超声诊断 【Abstract】 Objective To study the ultrasonic imaging characteristics and its diagnostic value for clonorchiasis.Methods 308 patients with clinically proved clonorchiasis were examined by ultrasonography.The ultrasonic imaging characteristics such as the intrahepatic duct dilatation，ductal and periductal echogenicity，floating plaques in gallbladder were analyzed.Results Among the 279 cases had changes on ultrasonic imaging.The main characteristics were the dilatation and thickened hyperechoic walls of intrahepatic bile ducts uniformly or segmentally，especially in Ⅱ，Ⅲ level intrahepatic ducts.Partly，the cystiform dilatation of intrahepatic bile ducts can seen in the edge of liver and floating plaques with postural variation in gallbladder.The bile ducts were full of uneven foci and dilated clearly when blocked by clonorchis sinensis，and the thickened hypoechoic walls were distinguished from liver parenchyma.In this group the accuracy rate，the sensitivity and specificity of diagnosing clonorchiasis with ultrasonography were 98.9%，90.3%，100% respectively.Conclusion The ultrasonic imaging of clonorchiasis has typical characterisitics，and ultrasonography is valuable in diagnosis of clonorchiasis，which is the first diagnostic method of images. 【Key words】 clonorchiasis ultrasonic diagnosis 华支睾吸虫病(Clonorchiasis)又称肝吸虫病，是一种广泛流行于亚洲(如中国、韩国)的人体寄生虫病［1］。随着饮食习惯的交流及生活的迁移，有扩大趋势，尤其在我国华南地区是高发区，感染率达408%［2］，值得广大医务工作者关注。肝吸虫病的诊断主要依赖于病史、临床表现，实验室检查及影像学检查(包括超声、CT和胆道造影)，其中超声检查起着重要的作用。但现有报道对超声声像图改变及其诊断价值持不同观点［1，3，4］。本文应用二维超声对308例华支睾吸虫病患者进行检查，旨在探讨其声像图特征及超声的临床应用价值。现报告如下。 1 资料与方法 1.1 一般资料