CAJ | 학술논문

目的分析肝脏肺吸虫病的常规超声及超声造影表现，以提高超声对其诊断正确率。方法19例肝脏肺吸虫患者，常规超声观测病变的数目、位置、大小、形态、边界及回声强度；其中8例行超声造影检查，观测其超声增强模式和强度。结果19例患者，17例为单发，2例多发，病灶共21个；病灶大小3.2 cm×2.5 cm~6.2 cm×5.0 cm；均为团状低回声；形态规则4例，欠规则8例；边界清楚9例，较清楚5例；内部回声不均匀18例；周边回声较强5例；周边均未见明显弱回声声晕；12例病灶内未见明显血流信号，7例周边或内部可见点状短线状血流信号。超声造影动脉相病灶周边呈高增强5例，等增强2例，低增强1例；8例团块内部为不均匀增强，内部可见大小不等无增强区。病灶门脉相及实质相均为低增强。结论当发现肝脏单发的形态不规则的实性占位，内部可见少许无回声区，超声造影显示肿块内有不规则隧道样无增强区时需考虑肝脏肺吸虫病的可能。
목적분석간장폐흡충병적상규초성급초성조영표현，이제고초성대기진단정학솔。방법19례간장폐흡충환자，상규초성관측병변적수목、위치、대소、형태、변계급회성강도；기중8례행초성조영검사，관측기초성증강모식화강도。결과19례환자，17례위단발，2례다발，병조공21개；병조대소3.2 cm×2.5 cm~6.2 cm×5.0 cm；균위단상저회성；형태규칙4례，흠규칙8례；변계청초9례，교청초5례；내부회성불균균18례；주변회성교강5례；주변균미견명현약회성성훈；12례병조내미견명현혈류신호，7례주변혹내부가견점상단선상혈류신호。초성조영동맥상병조주변정고증강5례，등증강2례，저증강1례；8례단괴내부위불균균증강，내부가견대소불등무증강구。병조문맥상급실질상균위저증강。결론당발현간장단발적형태불규칙적실성점위，내부가견소허무회성구，초성조영현시종괴내유불규칙수도양무증강구시수고필간장폐흡충병적가능。
Objective To analyze the sonographic characteristics of hepatic paragonimiasis on conventional and contrast-enhanced ultrasound (CEUS), and to improve the accuracy rate of ultrasonic diagnosis. Methods Nignteen patients with hepatic paragonimiasis were enrolled in this study, the number, location, size, shape, border and echogenicity were observed by conventional ultrasound. Among them, 8 patients underwent CEUS examination. The enhancement mode and enhancement intensity were observed. Results In the 19 patients, the lesion was solitary in 17 patients and multiple in 2 patients. The size of the lesion varied from 3.2 cm×2.5 cm to 6.2 cm×5.0 cm. The echogenicity of the lesions was all hypoechoic. The shape of the lesion was regular in 4 cases, partially regular in 8 cases and irregular in 7 cases. The border the lesions was demarcated in 9 cases, partially clear in 5 cases and unclear in 5 cases. The echotexture was homogeneous in 1 case and heterogeneous in the other 18 cases. Peripheral hyperechogenecity was identified in 5 cases and no hypoechoic rim was found in all cases. No color Doppler signals was found inside the lesions in 12 cases and dotty signals were identified in the other 7 cases. Among the 8 patients who underwent CEUS, peripheral hyperenhancement were found in 5 cases ,isoenhancement in 2 cases and hypoenhancement in the other 1case. All 8 cases were illustrated heterogeneous enhancement and irregular non-enhancement areas inside the lesion and hypo-enhancement in portal and parenchymal phase. Conclusion When a solitary irregular solid lesion is found in the liver and irregular unenhanced areas are shown on CEUS, the diagnosis of hepatic paragonimiasis should be considered.