胆道蛔虫病的超声诊断再认识  

Re-assessment of ultrasound diagnosis for biliary ascariasis

作　　者：傅英[1] 刘健[2] 李敬东[3] 

机构地区：[1]四川省犍为县人民医院,在读研究生614400 [2]四川省南充市川北医学院附属医院超声科 [3]四川省南充市川北医学院附属医院外三科

出　　处：《中华医学超声杂志（电子版）》2010年第10期65-66,共2页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的总结胆道蛔虫病超声声像图特征并分析漏诊原因。方法对54例腹部疼痛或阵发性剧痛,伴恶心呕吐及皮肤巩膜黄染等临床症状的胆道蛔虫病患者行腹部彩色多普勒超声检查,观察肝内、外胆管及胆囊内部回声情况,总结其声像图特点。结果 54例患者中术前超声检出胆道蛔虫44例(81.5%),漏诊10例。其中17例胆道蛔虫成活或虫体完整,声像图表现为肝内外胆管不同程度扩张,胆道内蛔虫呈1条或数条2～5mm宽双线状强回声带,可见虫体蠕动,前端圆钝,边缘清晰光整,中心贯穿的液性无回声为蛔虫假体腔,其内可出现回声点;27例为胆道蛔虫残骸,声像图特点为蛔虫虫体逐渐变得模糊,层次消失,图像欠典型,仅可见节段性等号状强回声或沉积于胆管后壁。结论超声检查可及时发现胆道蛔虫所在体内部位、虫体条数,对临床及时有效诊治提供重要参考依据。Objective To discuss the ultrasound diagnosis of biliary ascariasis and analyze the reasons for misdiagnosis. Methods To retrospectively analyse and summarize the characteristics of acoustic images in the 54 patients with biliary ascariasis diagnosed by surgical inspection. Results A total of 44 cases of biliary ascariasis were detected by preoperative ultrasound and the detection rate was 81.5%. Biliary ascariasis in 17 patients survived. Sonography showed dilatation of the extrahepatic bile, in which there was a roundworm or a few of 2-5 mm wide with two-line strong echoes. The squirming of the the biliary ascaris was shown by ultrasound, which had blunt front end, sharp edges and the liquid anechoic through the center of the roundworm. Twenty-seven cases were biliary ascariasis wreckage. The blurred ascaris body without layering and strong echoes of segmental equal or equal sign was shown by ultrasound. Conclusions The utrasound diagnosis can identify the site and number of biliary ascariasis, which were of important clinical value.

关 键 词：胆道蛔虫 超声检查 胆系感染 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.4[医药卫生—诊断学]