Choi Dongil, Jeon Yong Hwan, Lee Geun-Chan, Choi Min-Ho, Hong Sung-Tae
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Parasitol. 2009 Mar;47(1):19-23. doi: 10.3347/kjp.2009.47.1.19. Epub 2009 Mar 12.
We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) was observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.
我们测量了华支睾吸虫病流行高发地区患者接受治疗后超声检查结果的变化。在中国东北的一个村庄,共有347名居民粪便检查华支睾吸虫卵呈阳性,他们接受了吡喹酮治疗。其中,132例患者在治疗前和治疗后1年均接受了腹部超声检查,并对83例治愈患者的超声检查结果变化进行了比较。治疗前82例患者(98.2%)存在肝内胆管弥漫性扩张(DDIHD),治疗后80例(96.4%)存在,其中3例改善,1例加重,79例无变化。治疗前42例患者(50.6%)观察到胆管周围回声增强(IPDE),治疗后45例(54.2%)存在,其中5例改善,8例加重,70例无变化。治疗前32例患者(38.6%)检测到胆囊内漂浮的强回声灶(FEFGB),治疗后17例(20.5%)存在,其中20例改善,5例加重,58例无变化。仅FEFGB的改善具有统计学意义(P = 0.004)。目前的结果证实,治疗1年后DDIHD和IPDE仍然存在,但FEFGB显著降低。在重度流行地区,治疗1年后FEFGB的超声检查结果可能提示华支睾吸虫病活动。