Caremani M, Benci A, Maestrini R, Rossi G, Menchetti D
Infectious Disease Division, Arezzo Hospital, Italy.
J Clin Ultrasound. 1996 Nov-Dec;24(9):491-500. doi: 10.1002/(SICI)1097-0096(199611/12)24:9<491::AID-JCU1>3.0.CO;2-I.
The natural history of cystic hydatid disease (CHD) can be divided into two stages. The first is characterized by the proliferation of the parasite; the second is marked by involution, ie, when the hydatid undergoes spontaneous distress or is subjected to pharmacological treatment. Echography makes it possible to study this evolution and to evaluate the stages of this parasitic pathology. This study of the evolution of abdominal CHD in 81 patients suffering from 127 cysts, with or without Albendazole treatment suggests a new sonographic classification: type I: simple CHD; type II: multiple CHD, type III: with detachment of membrane CHD; type IV: mixed CHD, type V: heterogeneous CHD; type VI: hyperechogenic CHD; type VII calcified CHD. Forty-seven patients suffering from 90 cysts of types I, II, III, IV, and V were treated with Albendazole; 31, suffering from 34 CHD of types VI and VII, were not treated, as they were considered involutional; 3 patients with 3 cysts refused therapy. Albendazole treatment resulted in the disappearance of 9 and in the solidification of 62 cysts. Of the remaining cases of CHD, 10 cysts showed sonographic alterations and 5 showed no modifications. Surgery was necessary for 2 patients (4 cysts). This new classification seems to be an aid in the recognition of the natural and therapy-induced involution of CHD and seems to improve the evaluation of the efficaciousness of the therapy.
囊型包虫病（CHD）的自然病程可分为两个阶段。第一阶段的特征是寄生虫增殖；第二阶段的特征是退化，即当包虫发生自发退变或接受药物治疗时。超声检查能够研究这种演变过程并评估这种寄生虫病的各个阶段。这项对81例患有127个囊肿的腹部CHD患者（无论是否接受阿苯达唑治疗）的演变情况的研究提出了一种新的超声分类：I型：单纯CHD；II型：多发CHD；III型：有膜分离的CHD；IV型：混合型CHD；V型：不均质CHD；VI型：高回声CHD；VII型：钙化CHD。47例患有90个I、II、III、IV和V型囊肿的患者接受了阿苯达唑治疗；31例患有34个VI和VII型CHD的患者未接受治疗，因为他们被认为处于退化阶段；3例有3个囊肿的患者拒绝治疗。阿苯达唑治疗使9个囊肿消失，62个囊肿固化。在其余的CHD病例中，10个囊肿出现了超声改变，5个囊肿未出现变化。2例患者（4个囊肿）需要进行手术。这种新的分类似乎有助于识别CHD的自然退化和治疗引起的退化，并且似乎能改善对治疗效果的评估。
