McCarty M, Choudhri A H, Helbert M, Crofton M E
Department of Radiology, St Mary's Hospital, London.
Clin Radiol. 1989 Nov;40(6):582-5. doi: 10.1016/s0009-9260(89)80308-3.
Cryptosporidial infection is one of the recognised causes of diarrhoea in AIDS patients. It may also produce biliary tract disease. Fifteen out of 250 (6%) AIDS patients seen at our hospital had Cryptosporidial enteritis and five of the 15 (2% total) had clinical evidence of biliary tract disease. The radiological findings in these five patients are presented. Ultrasound examination of all five patients showed abnormalities in the biliary tree; five had dilatation and irregularity of the intra- and extrahepatic bile ducts with focal strictures, four had gall-bladder wall thickening, two had thickening of the common bile duct wall, two patients showed areas of increased reflectivity in the periductal regions of the liver and two had pancreatic duct dilatation. ERCP in one patient confirmed the ultrasound findings and Cryptosporidium oocytes were isolated from the collected bile. We conclude that Cryptosporidial infection in the biliary tree can produce distinctive appearances on ultrasound which may well obviate the need for more invasive investigations such as ERCP.
隐孢子虫感染是艾滋病患者腹泻的公认病因之一。它也可能引发胆道疾病。在我院就诊的250例艾滋病患者中，有15例（6%）患有隐孢子虫性肠炎，其中5例（占总数的2%）有胆道疾病的临床证据。现将这5例患者的影像学检查结果呈现如下。对所有5例患者进行超声检查均显示胆道树存在异常；5例肝内和肝外胆管有扩张、不规则及局灶性狭窄，4例胆囊壁增厚，2例胆总管壁增厚，2例患者肝脏胆管周围区域回声增强，2例胰管扩张。1例患者的内镜逆行胰胆管造影（ERCP）证实了超声检查结果，且从采集的胆汁中分离出了隐孢子虫卵囊。我们得出结论，胆道树中的隐孢子虫感染在超声检查中可呈现出独特表现，这很可能无需进行诸如ERCP等更具侵入性的检查。
