Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis
Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis
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DOI：
10.1007/s00261-007-9326-x
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发表时间：
2008-03-01
影响因子：
--
通讯作者：
Ahn, Geung Hwan
中科院分区：
文献类型：
--
作者：
Lim, Jae Hoon;Mairiang, Eimorn;Ahn, Geung Hwan
胆道树的寄生性感染是由肝吸虫引起的，即华支睾吸虫和华支睾吸虫。这些吸虫栖息在肝脏的外围小胆管中，导致慢性胆管炎、胆管扩张、机械性梗阻和胆管壁增厚。在影像上，周围小的肝内胆管扩张，但大胆管和肝外胆管不扩张或略有扩张。没有明显的梗阻原因。有时，在重度感染中，成人吸虫在超声、CT或MR胆管成像上显示为小的管腔内病变。在超声检查上，胆囊内的吸虫可能看起来像漂浮的小物体。慢性感染可能导致肝实质或沿胆管的胆管癌。人感染肝片吸虫是一种牛吸虫，可在不经意间发生，并在肝脏(肝期)和胆管(胆管期)迁徙。肝期影像表现为肝脏周围多个小而簇状的坏死腔或脓肿，呈“隧道和腔”征，反映寄生虫在肝实质内的迁徙。在胆道期，肝内外胆管和胆囊内的吸虫表现为小的管腔内扁平物体，有时自发运动。胆管扩张。
Parasitic infection of the biliary tree is caused by liver flukes, namely Clonorchis sinensis and Opisthorchis viverrini. These flukes reside in the peripheral small bile ducts of the liver and produce chronic inflammation of the bile duct, bile duct dilatation, mechanical obstruction, and bile duct wall thickening. On imaging, peripheral small intrahepatic bile ducts are dilated, but the large bile ducts and extrahepatic bile ducts are not dilated or slightly dilated. There is no visible caused of obstruction. Sometimes, in heavy infection, adult flukes are demonstrated on sonography, CT or MR cholangiography as small intraluminal lesions. The flukes in the gallbladder may appear as floating, small objects on sonography. Chronic infection may result in cholangiocarcinoma of the liver parenchyma or along the bile ducts. Human infection of Fasciola hepatica, a cattle flukes, may occur inadvertently, and the flukes migrate in the liver (hepatic phase) and reside the bile ducts (biliary phase). Image findings in the hepatic phase present with multiple, small, clustered, necrotic cavities or abscesses in the peripheral parts of the liver, showing "tunnels and caves" sign, reflecting parasite migration in the liver parenchyma. In the biliary phase, the flukes are demonstrated in the intra- and extrahepatic bile ducts and the gallbladder as small intraluminal flat objects, sometimes moving spontaneously. Bile ducts are dilated.