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以肝外受累为重点的包虫病影像学检查

Imaging of Hydatid Disease with a Focus on Extrahepatic Involvement.

作者信息

Zalaquett Eugenio, Menias Christine, Garrido Francisco, Vargas Matías, Olivares José Francisco, Campos Daniel, Pinochet Natalia, Luna Antonio, Dahiya Nirvikar, Huete Álvaro

机构信息

From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.).

出版信息

Radiographics. 2017 May-Jun;37(3):901-923. doi: 10.1148/rg.2017160172.

Abstract

Hydatid disease (HD) is a parasitic infection caused by the larvae of a tapeworm that is endemic to many regions around the world-South America, Africa, and Asia, in particular. Humans are infected as intermediate hosts in the parasite's life cycle; thus, HD can be seen in persons living in areas where animal husbandry is practiced. However, owing to the varied patterns of migration and immigration during the past several decades, HD can be diagnosed in individuals living anywhere. The liver is the most common organ involved, with hepatic HD accounting for the majority of published cases. However, HD can affect multiple organs and tissues other than the liver, including the spleen, kidneys, lungs, heart, peritoneum, muscles, and brain. Knowledge of the route of spread, clinical findings at presentation, and possible complications involving each extrahepatic location can be useful for the radiologist when evaluating imaging findings in patients suspected of having HD. The ultrasonographic, computed tomographic, and magnetic resonance imaging findings of extrahepatic hydatid lesions frequently simulate those of hepatic HD, as long as rupture, bleeding, and/or superimposed bacterial infection has not occurred. Specific features of HD seen at different extrahepatic sites can help tailor the diagnosis. The differential diagnoses that can mimic HD at every nonhepatic location should be considered, as many of these entities are common, especially in nonendemic areas. RSNA, 2017.

摘要

包虫病(HD)是一种由绦虫幼虫引起的寄生虫感染,在世界许多地区流行,尤其是南美洲、非洲和亚洲。人类在寄生虫的生命周期中作为中间宿主被感染;因此,HD可见于从事畜牧业地区的人群。然而,由于过去几十年中移民和迁徙模式的变化,HD可在任何地方居住的个体中被诊断出来。肝脏是最常受累的器官,肝包虫病占已发表病例的大多数。然而,HD可累及肝脏以外的多个器官和组织,包括脾脏、肾脏、肺、心脏、腹膜、肌肉和大脑。了解传播途径、临床表现以及每个肝外部位可能出现的并发症,对于放射科医生评估疑似HD患者的影像学表现可能会有所帮助。只要未发生破裂、出血和/或叠加细菌感染,肝外包虫病变的超声、计算机断层扫描和磁共振成像表现通常与肝包虫病相似。在不同肝外部位看到的HD的特定特征有助于做出诊断。应考虑在每个非肝脏部位可能模拟HD的鉴别诊断,因为其中许多疾病很常见,尤其是在非流行地区。RSNA,2017年。

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