Kardorff R, Döhring E
Marien-Hospital Wesel, Kinderklinik.
Ultraschall Med. 2001 Jun;22(3):107-15. doi: 10.1055/s-2001-15244.
Schistosomiasis (Bilharzia, Bilharziasis) is one of the most prevalent tropical diseases, with an increasing number of cases being imported into Europe. Sonography is among the most valuable diagnostic tools for schistosomiasis-related organ lesions. This review outlines typical findings and their pathophysiological context.
Bilharziasis of the urinary tract, usually due to Schistosoma (S.) haematobium, leads to diffuse or localized wall thickening of the bladder and the distal ureter with typical sonographic features. Upper urinary tract obstruction and--rarely--bladder carcinoma may complicate the course and can also be detected sonographically. The other species (S. mansoni, S. japonicum, S. mekongi, S. intercalatum) primarily cause (entero-) colitis; the value of sonography in this condition is yet undefined. In later stages, fibrotic liver involvement with portal hypertension may develop (hepatosplenic schistosomiasis), leading to typical ultrasound features which are nearly pathognomonic under endemic conditions: severe periportal echogenicity with S. mansoni, and a peculiar "network pattern" of echogenic septa with S. japonicum. Sonographic indicators of portal hypertension may be identified and graded.
In endemic areas in the tropics, sonography with simple portable machines offers a unique opportunity to investigate morbidity on the community level non-invasively in large field surveys; it has thus become an important tool of clinical and epidemiological research.
血吸虫病是最常见的热带疾病之一，输入欧洲的病例数不断增加。超声检查是诊断血吸虫病相关器官病变最有价值的工具之一。本综述概述了典型表现及其病理生理背景。
尿路血吸虫病通常由埃及血吸虫引起，导致膀胱和远端输尿管壁弥漫性或局限性增厚，具有典型的超声特征。上尿路梗阻以及罕见的膀胱癌可能使病情复杂化，也可通过超声检测到。其他种类（曼氏血吸虫、日本血吸虫、湄公血吸虫、间插血吸虫）主要引起（肠）结肠炎；超声检查在这种情况下的价值尚不清楚。在后期，可能会出现伴有门静脉高压的肝纤维化（肝脾型血吸虫病），导致典型的超声特征，在流行地区几乎具有诊断意义：曼氏血吸虫感染时门静脉周围回声增强明显，日本血吸虫感染时出现独特的回声间隔“网状模式”。可以识别并分级门静脉高压的超声指标。
在热带流行地区，使用简单的便携式机器进行超声检查为在大型现场调查中以非侵入性方式在社区层面调查发病率提供了独特的机会；因此，它已成为临床和流行病学研究中的一项重要工具。
