胆道蛔虫的超声诊断价值

Diagnostic value of ultrasound in biliary ascariasis

目的探讨超声对胆道蛔虫的诊断价值。方法分析54例胆道蛔虫病患者的胆道声像图特点。结果胆道蛔虫成活或虫体完整20例,术前超声检出17例,声像图示肝外胆管呈不同程度扩张,其内有一条或多条2～5mm宽的双线状强回声;超声漏诊2例胆总管内蛔虫,1例胆囊内蛔虫因合并多发结石。胆道蛔虫残骸者34例,超声检出27例,声像图示蛔虫体逐渐变得模糊,层次消失,仅可见节段性的等号状强回声;漏诊2例因合并胆管癌,5例因合并胆总管结石或胆囊结石,蛔虫残骸与癌肿、结石回声重叠。结论超声检查对胆道蛔虫有较高的诊断价值。

Objective To explore the diagnostic value of ultrasound in biliary ascariasis. Methods The sonogram features of 54 patients with biliary ascariasis were analyzed. Results There were 44 cases of biliary ascariasis detected by ultrasound before operation, the detection rate was 81.5%. Twenty cases were with survive biliary parasites, or parasites survived completely, including 17 cases detected by ultrasound. The sonogram showed different degree expansion of extrahepatic bile duct, and its internal roundworm showed one or more of 2 - 5ram wide, linear hyperechoic band with blunt front, clear edge, and liquid dark bands through the center, catapoints appeared in its interior. Two cases with roundworm in the common bile duct （CBD） and 1 case complicated with stones in the gallbladder were missed diagnosed. Thirty -four cases were with remnant of biliary parasites,including 27 cases detected by ultrasound. The sonogram showed the parasites became undefined, the layer disappeared, only segmental strong echo was found, or deposited in bile duct posterior wall. Two cases complicated with cholangiocarcinoma and 5 cases complicating with stones in the CBD or gallbladder were missed diagnosed for echo overlap of roundworm remnant and carcinoma or stones on images. Conclusion Ultrasonography has important value in diagnosis of biliary ascariasis.