非牧区肝包虫病的影像学诊断与分析

Imaging Diagnosis and Analysis of Hepatic Echinococcosis in Non-Pastoral Area

摘要: 目的：探讨非牧区肝包虫病的影像学特点，提高对本病的认识，降低误诊率。方法：回顾性分析我院2023年1月~2024年12月经手术病理证实的6例肝包虫病患者资料，严格设定纳入与排除标准，采用双盲法阅片并统一影像评估标准。结果：6例中无牧区居住史4例，有牧区居住史2例；出现“双壁征”“飘带征”共5例，囊内见钙化及点状脂肪1例，合并外囊破裂、腹腔积液及广泛种植2例。CT检查4例中正确诊断3例，MRI检查4例中正确诊断2例，超声检查2例中正确诊断1例。结论：非牧区与牧区肝包虫病影像学表现基本一致，“双壁征”“飘带征”为典型征象；非牧区诊断仍易误诊，需加强影像医师对本病的识别能力，做到早诊早治。

Abstract: Objective: To investigate the imaging features of hepatic echinococcosis in non-pastoral areas, improve the understanding of this disease, and reduce the misdiagnosis rate. Methods: Clinical and imaging data of 6 patients with surgically and pathologically confirmed hepatic echinococcosis in our hospital from January 2023 to December 2024 were retrospectively analyzed. Strict inclusion and exclusion criteria were applied. All images were reviewed independently by two blinded radiologists with unified evaluation criteria. Results: Among the 6 patients, 4 had no history of living in pastoral areas and 2 had such a history. The “double-wall sign” and “streamer sign” were found in 5 cases, calcification and punctate fat inside the cyst in 1 case, and external cyst rupture with ascites and extensive abdominal implantation in 2 cases. CT correctly diagnosed 3 of 4 cases, MRI correctly diagnosed 2 of 4 cases, and ultrasound correctly diagnosed 1 of 2 cases. Conclusion: Imaging manifestations of hepatic echinococcosis in non-pastoral areas are basically consistent with those in pastoral areas. The “double-wall sign” and “streamer sign” are typical features. Misdiagnosis remains common in non-pastoral areas. Radiologists in these regions should strengthen the recognition ability to achieve early diagnosis and treatment.