肝臟日本血吸蟲病之超音波診斷

HEPATIC SCHISTOSOMIASIS JAPONICUM IDENTIFIED BY SONOGRAPHY

秦德萍(Teh-Pin Chin) ； 李三剛(San-Kan Lee)

《中華放射線醫學雜誌》 13卷2期 (1988/06) Pp. 175-179

摘要

日本血吸蟲病（schistosomiasIs japonicum）流行於中國大陸、台灣、日本及菲律賓。但是在台灣的血吸蟲是一種動物型，並未發現侵入人類。由民國71年至76年間，在三軍總醫院，陸軍入八○五總醫院共發現了11例患者，男性10例、女性1例、平均年齡62歲，他們皆曾居住於長江流域省分，來台灣也超過30年。主要的超音波發現包括（1）門脈周圍纖維化形成所謂細網狀化龜背樣圖案，此纖維化之分佈並不一定是均勻狀。（2）中隔纖維化。（3）肝被囊纖維化。共有9，5，4例分別呈現上述之3種變化，依據上面三種變化，我們可將患者分為三個等級，第一級為無上述三種變化或變化不明顯，難以診斷，共有2例。第二級具較明顯的門脈周圍纖維化，並形成細網時，共有4例屬於此一級。第三組為明顯的細網狀或龜背樣變化，或具有中隔狀纖維化，或肝臟被囊纖維化，有5例列入此一級。另外脾腫大者僅一人，有腹水者二人。根據上面的發現，超音波可提供具診價值的資料。

關鍵字

日本血吸蟲病(schistosomiasIs japonicum)

並列摘要

Schistosomiasis Japonicum is endemic in mainland China, Taiwan, Japan, and Phliippine. But in Taiwan it is an animal strain and there is no report of infestation to man. From 1982 to 1987, there are 8 cases found in Tri-Service General Hospital and 3 cases in Army 805 General Hospital. They are ten male and came from mainland China for more than 30 years. The main sonographic findings include 1. periportal fibrosis. or ＂turtle back＂ appearance which may be uneven distribution. 2. septal fibrosis. 3. capsular fibrosis. According to these, we categorize our cases into three grades. Grade I is defined as no definite above three findings or subtle periportal fibrosis. Grade II shows fine periportal fibrosis but no septal fibrosis or capsular fibrosis. Grade III: apparent turtle back fibrosis with or without septum fibrosis and capsular fibrosis. There are 2, 4, 5 cases in Gr I, II, III respectively. Splenomegaly is noted in one case only. ascites in two cases. According to the above characteristic findings, in diagnosis of schistosomiasis, sonography is easy to use and can supply almost diagnositic information.