Giorgio A, Tarantino L, de Stefano G, Francica G, Aloisio T, Pierri P, Scala V, Pierri G
V Divisione, Ospedale Specializzato per Malattie Infettive D. Cotugno, Napoli.
Radiol Med. 1991 Oct;82(4):460-4.
Fourteen patients (9 females, 5 males; age range: 22-80 years) with 16 univesiculated hydatid cysts of the liver (O ranging 4.2-14 cm) underwent two sessions of puncture-aspiration-alcohol injection (D-PAI) under real-time US guidance at 3-day intervals. Two patients had postoperative recurrences. One patient was pregnant (9 weeks' gestation): her cyst doubled its volume over 2 months. One patient had HBV chronic hepatitis treated by means of interferon: also in this case the cyst doubled its volume. The remaining were high-risk patients for surgery or had refused operation. At US follow-up (ranging 4-24 months) 6 cysts exhibited complete reconstitution of liver parenchyma. In the extant patients two different US patterns were observed: 1) liquid areas with detached inner membranes (4 cysts); 2) solid inhomogeneous areas (6 cysts). In these cases the volume was reduced by 50-80%. No allergic complication occurred either during or after the procedure. Two patients only were affected with vomiting and fever, which resolved in a few hours. Our results indicate D-PAI of univesiculated hydatid cysts of the liver to be an effective alternative to surgery.
14例患者(9例女性,5例男性;年龄范围:22 - 80岁),共16个肝脏单房性包虫囊肿(直径4.2 - 14 cm),在实时超声引导下每隔3天接受两次穿刺抽吸酒精注射(P - AI)治疗。2例患者术后复发。1例患者怀孕(妊娠9周):其囊肿在2个月内体积增大一倍。1例患者患有慢性乙型肝炎,接受干扰素治疗:该病例中囊肿同样在2个月内体积增大一倍。其余患者为手术高危患者或拒绝手术。在超声随访(4 - 24个月)中,6个囊肿肝实质完全重建。在其余患者中观察到两种不同的超声表现:1)内部有分离内膜的液性区域(4个囊肿);2)实性不均匀区域(6个囊肿)。在这些病例中,囊肿体积缩小了50% - 80%。术中及术后均未发生过敏并发症。仅2例患者出现呕吐和发热,数小时后缓解。我们的结果表明,肝脏单房性包虫囊肿的P - AI是一种有效的手术替代方法。