International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings
International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings
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DOI：
10.1016/s0001-706x(02)00213-9
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发表时间：
2003-02-01
期刊：
影响因子：
2.7
通讯作者：
Hao, W
中科院分区：
文献类型：
--
作者：
Macpherson, CNL;Vuitton, DA;Hao, W
由于最近在现场和临床研究中扩大了超声（US）的使用，因此对囊状棘球蚴病（CE）自然史的了解增加，有必要制定新的WHO标准化US图像分类。使用这种分类将使临床医生能够检查不同类型囊肿的推荐临床手术。它还将使科学家能够比较世界不同地区发生囊肿类型的数据，为检查病原体细粒棘球绦虫的菌株差异提供证据。建议的分类遵循Gharbi等人[Radiology 139（1981）459]开发的第一种分类，该分类自出版以来已被广泛使用，但形式有所修改。这里提出的分类是为了在现场流行病学研究以及临床研究者使用。该分类旨在遵循CE的自然史，并从未分化的简单囊肿开始，因为推测包虫囊肿是从这些结构演变而来的。然而，这些简单的囊肿可能是由于许多不同的病因（寄生虫病，先天性疾病，胆管囊肿或肿瘤），因此，需要进一步的诊断测试，以揭示其身份。由于其起源不确定，因此未将其指定为CE型病变，在建议的分类中，应记录为囊性病变（CL）。第一个临床组从CE I和2型囊肿开始，这些囊肿是活跃的，通常是含有活原孢子的可育囊肿。CE 3型是进入过渡阶段的囊肿，其中囊肿的完整性已被宿主或化疗损害，并且该过渡阶段被分配给第二临床组。第三临床组包括CE 4型和5型，它们是非活动性囊肿，通常失去生育能力并且是退行性的。使用标准化的美国分类将有助于应用目前推荐用于每种囊肿类型的统一标准和治疗原则。(C)2002 Elsevier Science B.V.保留所有权利。
The increased knowledge of the natural history of cystic echinococcosis (CE) by the recent expansion in the use of ultrasound (US) in field and clinical studies has necessitated the development of a new WHO standardised classification of US images. Use of such a classification will enable clinicians to examine recommended clinical procedures for the different cyst types. It will also allow scientists to compare data on the occurrence of cyst types in different parts of the world providing evidence to examine strain differences in the causative organism Echinococcus granulosus. The classification proposed follows that of the first classification developed by Gharbi et al. [Radiology 139 (1981) 459] which has been widely used, but in modified forms, since its publication. The classification presented here is intended for use in field epidemiological studies as well as for clinical investigators. The classification is intended to follow the natural history of CE and starts with undifferentiated simple cysts, as presumably hydatid cysts evolve from these structures. These simple cysts, however, may be due to a number of different aetiologies (parasitic lesions, congenital disorders, biliary cysts or neoplasms) and, therefore, require further diagnostic tests to reveal their identity. As their origin is uncertain they are not given the designation of a CE type lesion, and, in the proposed classification, should be recorded as cystic lesions (CL). The first clinical group starts with cyst types CE I and 2 and such cysts are active, usually fertile cysts containing viable protoscoleces. CE Type 3 are cysts entering a transitional stage where the integrity of the cyst has been compromised either by the host or by chemotherapy and this transitional stage is assigned to the second clinical group. The third clinical group comprises CE Types 4 and 5 which are inactive cysts which have normally lost their fertility and are degenerative. The use of the standardised US classification will facilitate the application of uniform standards and principles of treatment currently recommended for each cyst type. (C) 2002 Elsevier Science B.V. All rights reserved.