超声及CT对囊性肝包虫病的分型在诊治中的价值探讨

Value of ultrasound and CT in diagnosis of cystic hydatidosis in liver

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。

Objective To explore the value of ultrasound and CT in diagnosis of cystic hydatidosis in liver.Methods Both ultrasound and CT images of 105 patients who was confirmed by operation and pathological examination were reviewed,and they were classified as type CE1,CE2,CE3 a,CE3 b,CE4 and CE5 according to the criteria by WHO.The ultrasonic features of each type was summarized.Taken surgical results as standard,the maximum diameter of cyst measured by ultrasound and CT was compared.Results In 105 patients,there were 9 cases of type CE1,13 cases of type CE2,12 cases of type CE3 a,24 cases of type CE3 b,22 cases of type CE4,and 25 cases of type CE5.Type CE1 mainly appeared as unilocular,anechoic cyst with double line sign.Type CE2 mainly appeared asmultiseptate＂rosette-like＂or＂honeycomb patern＂cyst.Type CE3 a mainly appeared as cyst with detached membrane（water-lily sign）. Type CE3 b mainly appeared as daughter cysts in solid matrix. Type CE4 appeared as heterogeneous cyst without daughter vesicules.Type CE5 appeared as solid matrix with calcified wall.The maximum diameter of cyst measured by ultrasound and CT were（10.50±5.37）cm and（9.90±5.04）cm,there were no significant difference compared with surgical specimen measurement[（10.50 ±5.64）cm].Conclusion Ultrasound and CT can reflect the various pathologic changes of different type of cystic hydatidosis,which demonstrated a great value in assessment of cystic hydatidosis in liver.