中国寄生虫学与寄生虫病杂志 ›› 1990, Vol. 8 ›› Issue (4): 298-301.

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肝细粒棘球蚴病超声影象的病理基础探讨

吕健,邹培范,王云海   

  1. 新疆医学院第一附属医院普外科
  • 收稿日期:2017-01-09 修回日期:2017-01-09 出版日期:1990-11-30 发布日期:2017-01-09

AN APPROACH TO THE PATHOLOGIC BASIS OF ULTRASONOGRAPHY IN HEPATIC HYDATID DISEASE

  • Received:2017-01-09 Revised:2017-01-09 Online:1990-11-30 Published:2017-01-09

摘要: 对98例原发性肝细粒棘球蚴病人,149个肝包虫囊肿进行了超声影象学分型和组织病理学观察。结果表明,超声分型基本上可反映肝细粒棘球蚴囊肿发展阶段的病理特征,可看出随着患者年龄增长,包虫囊肿有由Ⅰ型至Ⅴ型转化的趋势。组织学观察表明,这一转化过程伴随着细粒棘球蚴囊肿自身损伤的逐渐加重。反映了肝细粒棘球蚴囊肿发生、发展和衰亡的规律。结果还表明,在肝细粒棘球蚴病例中,活力基本正常、损伤和死亡的囊肿约各占1/3。上述结果可供肝细粒棘球蚴病化疗中评价疗效时参考。

关键词: 肝细粒棘球蚴囊肿, 超声影象, 病理学

Abstract: The relationship between sonographic image and histological findings of 149 hepatic hydatid cysts was studied in 98 patients with primary hepatic hydatid disease. Sonographic classification was based on the morphology and structure of the cyst, which is thought to correspond to developmental stages of the hydatid cyst. The types were classified as follow: Type Ⅰ: simple fluid-filled cyst denoted as the early stage of the disease; Type Ⅱ: with undulated membrane representing detached endocysts secondary to rupture; Type Ⅲ: with daughter cysts and a formed echogenic material called matrix; Type Ⅳ: solid cyst filled with matrix; Type Ⅴ: calcified cyst. The latter two types were dead cysts, denoting the end of natural fate of the cyst. The natural progression of the cyst from Type Ⅰ to TypeⅤ was correlated with increasing age of the patients. The rate of stainable protoscolices corresponded to the degree of damage of the germinal membrane, which could reflect the viability of hydatid cyst. The damage of germinal membrane happened earlier and was more severe than that of the protoscolices?being the biologic basis of transforming from type Ⅱ into type Ⅲ. Our study also showed that normal, damaged and dead cysts accounted for about 1/3 respectively in the clinical cases of hepatic hydatid disease, providing references for evaluating chemotherapeutic effects on hepatic hydatidosis.