Ralls P W, Barnes P F, Radin D R, Colletti P, Halls J
AJR Am J Roentgenol. 1987 Sep;149(3):499-501. doi: 10.2214/ajr.149.3.499.
We blindly compared the sonographic findings in amebic (112 lesions) and pyogenic (30 lesions) liver abscesses. Two sonographic features were significantly more prevalent in amebic abscesses: the lesions had a round or oval shape and the lesions had an echogenicity that was lower than that of normal liver and were internally homogeneous on high-gain scans. Amebic abscesses were round or oval in 92 instances (82%), while 18 pyogenic abscesses (60%) (p less than .01) had these shapes. Fifty-nine (58%) of 101 amebic abscesses displayed low echogenicity and homogeneous internal echoes with high-gain settings compared with nine (36%) of 25 pyogenic abscesses (p less than .04). Despite these different sonographic patterns, image findings alone were inadequate in distinguishing pyogenic from amebic liver abscesses. However, when the sonographic findings were coupled with clinical and laboratory data, a correct diagnosis was possible in 83 (86%) of 96 patients with amebic abscess. It appears that, although some sonographic features of amebic abscess differ from those of pyogenic abscess, these differences are not sufficient to allow a specific diagnosis on the basis of sonography alone. Sonography can expedite abscess detection and, when coupled with clinical and laboratory data, can aid in differentiating pyogenic from amebic liver abscesses.
我们盲目地比较了阿米巴肝脓肿（112个病灶）和化脓性肝脓肿（30个病灶）的超声检查结果。有两个超声特征在阿米巴脓肿中更为常见：病灶呈圆形或椭圆形，且病灶的回声低于正常肝脏，在高增益扫描下内部均匀。92例（82%）阿米巴脓肿呈圆形或椭圆形，而18例化脓性脓肿（60%）（p<0.01）呈这些形状。101例阿米巴脓肿中有59例（58%）在高增益设置下显示低回声且内部回声均匀，相比之下，25例化脓性脓肿中有9例（36%）如此（p<0.04）。尽管有这些不同的超声表现，但仅靠图像结果不足以区分化脓性肝脓肿和阿米巴肝脓肿。然而，当超声检查结果与临床和实验室数据相结合时，96例阿米巴脓肿患者中有83例（86%）能够做出正确诊断。看来，尽管阿米巴脓肿的一些超声特征与化脓性脓肿不同，但这些差异不足以仅凭超声做出明确诊断。超声检查可以加快脓肿的检测，并且与临床和实验室数据相结合时，有助于区分化脓性肝脓肿和阿米巴肝脓肿。
