多模态超声检查技术在1例儿童罕见早期肝囊型包虫病诊断与随访中的应用  

Diagnose and follow-up a rare child case suffering from early hepatic cystic echinococcosis by using multimodality ultrasonographic techniques

作　　者：王逸非 万敏 蔡迪明[1] 陈娟[1] 李永忠[1] WANG Yi-fei;WAN Min;CAI Diming;CHEN Juan;LI Yong-zhong(West China Hospital of Medicine:Sichuan University West China Hospital,Chengdu 610000,Sichuan Province,China;West China Women's and Children's Hospital:Sichuan University West China Second University Hospital,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院,成都610041 [2]四川大学华西第二医院,成都610041

出　　处：《预防医学情报杂志》2022年第4期552-556,共5页Journal of Preventive Medicine Information

摘　　要：目的肝囊型包虫病早期症状隐匿,且超声影像学表现可能不典型,易误诊和漏诊。现探讨多模态超声在早期肝囊型包虫病的诊断价值。方法对患儿进行病史采集、问诊查体,进行血清学抗体检测,采用多模态超声检查技术采集进行评估以获取临床诊断依据。在药物治疗过程中,使用多模态超声检查技术对定期对病灶大小及超声形态学特征变化进行观察。结果在肝脏发现两个病灶,其中一个病灶为罕见的CL型囊型包虫病,另一个为CE1型病灶的早期阶段。在随访过程中两个病灶均呈现出肝囊型包虫病病灶的退变过程,分别由CL、CE1型退变为CE3及CE4型。结论本研究采用多模态超声检查技术诊断与随访肝囊型包虫病CL型和CE1型病灶,提供了罕见的CL型存在的临床证据,提示基层筛查中和医院检查中应对该类病灶予以重视。此外,也表明多模态超声检查技术在早期肝囊型包虫病的诊断中有一定价值。Objective Human cystic echinococcosis(CE)is a zoonotic parasitic disease caused by larvae stage of the Echinococcus granulosus s.l..Patients with early stage lesions are often asymptomatic,which is easy to be misdiagnosed and missed.This study aimed to diagnose and follow-up a rare child case with early hepatic CE by using multimodality ultrasonographic techniques,and explore the application value of multimodality ultrasonographic techniques in the diagnosis of early hepatic cystic echinococcosis.Methods Medical history,physical examination,serology examination and other laboratory tests,multimodality ultrasonographic techniques were conducted to make clinical diagnosis.During medical treatment,multimodality ultrasonographic techniques were performed to observe the changes of ultrasonographic manifestation and size of the lesions.Results Two lesions were found in the liver;one was rare CE type CL(cystic lesion),and the other was the early stage of CE type 1(CE1).During the follow-up,both lesions showed the degeneration process of hepatic cystic echinococcosis,from CL and CE1 to CE type3(CE3)and CE type 4(CE4),respectively.Conclusions This study used multimodality ultrasonographic techniques to present images of cystic echinococcosis type CL(CL)and cystic echinococcosis type 1(CE1)lesions and their degeneration process,providing evidence to show the existence of CE Type CL clinically.The finding prompts that during both community-based screening and hospital-based examination,this kind of lesion should be paid more attention to avoid misdiagnosing and missing of cases.Our findings also showed the value of application of multimodality ultrasonographic techniques in the diagnosis of early hepatic cystic echinococcosis.

关 键 词：早期肝囊性包虫病 多模态超声检查技术 儿童 

分 类 号：R532.32[医药卫生—内科学]