Fornell-Perez Roberto, Urizar-Gorosarri Maite, Martinez-Urabayen Uxue, Perez-Bea Marta
Radiology Department, Basurto Universitary Hospital, Bilbao, Vizcaya, Spain.
Insights Imaging. 2023 Nov 13;14(1):187. doi: 10.1186/s13244-023-01511-9.
To assess the frequency of appearance of various signs (isolated and grouped) in emergency imaging tests in patients with anisakiasis, according to the location of gastrointestinal tract involvement.
Retrospective review by two experienced radiologists of emergency ultrasounds and CTs performed on patients admitted in the Emergency Department of our hospital with later confirmed anisakiasis (2010-2021), assessing the presence of signs suggesting anisakiasis. Calculation of the frequency of appearance according to the gastric or intestinal location, as well as the most common grouped signs.
Out of 231 total patients with anisakiasis, imaging studies were performed in 144: abdominopelvic ultrasound in 43 cases and CT in 111 (both techniques in 31). In cases with gastric occurrence (34), in CT the wall stratification (100%), wall thickening (97%), fat stranding (91%) and ascitic fluid (82%) were predominant. In the intestinal cases (105), in CT (95) the wall thickening (100%), fat stranding (92%) and mesenteric vessel engorgement (83%) were usual; in ultrasound (40), ascitic fluid and wall thickening (70% in both cases) were frequently observed. The frequency of grouped appearance of the mentioned signs was 82% in gastric cases, 80% in intestinal cases and 50% in ultrasounds. Multisegment involvement in CT reached 28% (gastric + intestinal) and 11% (only intestinal) of cases.
The most frequent CT findings in patients with gastric anisakiasis are wall stratification and thickening, fat stranding and ascitic fluid. In the intestinal cases, wall thickening, fat oedema and vessel engorgement are the most often observed findings.
The presence of different radiological signs makes it advisable to include anisakiasis in the differential diagnosis of acute abdomen. Intestinal and multifocal involvement rates are greater than previously reported.
• In gastric anisakiasis, CT frequently shows wall stratification and thickening, fat stranding and ascitic fluid. • In intestinal anisakiasis, CT often presents wall thickening, fat stranding and vessel engorgement. • In intestinal anisakiasis, ultrasounds most frequently show ascitic fluid and wall thickening.
根据胃肠道受累部位，评估异尖线虫病患者急诊影像检查中各种体征（孤立和聚集性）出现的频率。
两位经验丰富的放射科医生对我院急诊科收治的、后来确诊为异尖线虫病的患者（2010 - 2021年）进行的急诊超声和CT检查进行回顾性分析，评估提示异尖线虫病的体征的存在情况。根据胃部或肠道位置计算出现频率，以及最常见的聚集性体征。
在总共231例异尖线虫病患者中，144例进行了影像学检查：43例进行了腹部盆腔超声检查，111例进行了CT检查（31例同时采用了两种检查技术）。在胃部发病的病例（34例）中，CT检查主要表现为胃壁分层（100%）、胃壁增厚（97%）、脂肪条索征（91%）和腹水（82%）。在肠道病例（105例）中，CT检查（95例）常见的表现为肠壁增厚（100%）、脂肪条索征（92%）和肠系膜血管充血（83%）；超声检查（40例）中，常见腹水和肠壁增厚（两者均为70%）。上述体征聚集出现的频率在胃部病例中为82%，肠道病例中为80%，超声检查中为50%。CT检查中多节段受累的病例占28%（胃 + 肠）和11%（仅肠道）。
胃部异尖线虫病患者最常见的CT表现为胃壁分层和增厚、脂肪条索征和腹水。在肠道病例中，最常观察到的表现为肠壁增厚、脂肪水肿和血管充血。
不同的放射学体征表明，在急腹症的鉴别诊断中应考虑异尖线虫病。肠道和多灶性受累率高于先前报道。
• 在胃部异尖线虫病中，CT常显示胃壁分层和增厚、脂肪条索征和腹水。• 在肠道异尖线虫病中，CT常表现为肠壁增厚、脂肪条索征和血管充血。• 在肠道异尖线虫病中，超声最常显示腹水和肠壁增厚。
