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1.
Medicine (Baltimore) ; 99(15): e19753, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282737

RESUMO

Human echinococcosis has become a major public health problem in most parts of the world. The objective of this article was to study the demographics of patients with hepatic echinococcosis in Ganzi County to elucidate the main risk factors, as well as to report the concurrent prevalence of cerebral echinococcosis and pulmonary echinococcosis.We recruited 195 patients with hepatic echinococcosis from the Datongma area of Ganzi County from January 2018 to November 2018. The patients' demographics, living environments, supported medical resources, knowledge of echinococcosis prevention and control, and hygienic practices were investigated and analyzed. The prevalence of cerebral echinococcosis and pulmonary echinococcosis were also investigated.The data were analyzed to identify risk factors for human echinococcosis. Our analysis showed that the herding Tibetan population within the 20 to 60 age group, and females, in particular, were at the highest risk of human echinococcosis infection. Having stray dogs around habitations and intimate activities with dogs and livestock were also behavioral risk factors. People with poor health literacy and low educational qualifications had possible risks of infection. In terms of hygiene, not using tap water as the drinking water source and lack of medical staff were significantly correlated with echinococcosis prevalence. Four patients were diagnosed with cerebral echinococcosis. Among them, 1 patient had both cerebral echinococcosis and pulmonary echinococcosis.Possible high-risk factors for echinococcosis were being female, herding population, in the 20 to 60 age group, having stray dogs around habitations, having activities with dogs and livestock, having poor health literacy, having low educational qualifications, and not using tap water as a drinking water source. The detection rate for brain echinococcosis in patients with hepatic echinococcosis was high (2.05%). Effective preventive strategies should be implemented in epidemic areas. Head CT scans should be applied for early detection of cerebral echinococcosis to carry out the treatment.


Assuntos
Cistos do Sistema Nervoso Central/parasitologia , Equinococose Hepática/epidemiologia , Equinococose Pulmonar/epidemiologia , Doenças Negligenciadas/epidemiologia , Neurocisticercose/diagnóstico por imagem , Adulto , Animais , Cistos do Sistema Nervoso Central/patologia , China/epidemiologia , Estudos Transversais , Cães , Equinococose Hepática/diagnóstico por imagem , Equinococose Pulmonar/complicações , Echinococcus granulosus/isolamento & purificação , Echinococcus multilocularis/isolamento & purificação , Feminino , Letramento em Saúde/tendências , Humanos , Higiene/normas , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/parasitologia , Doenças Negligenciadas/prevenção & controle , Neurocisticercose/complicações , Neurocisticercose/epidemiologia , Prevalência , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos
3.
Can Assoc Radiol J ; 71(1): 12-18, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32063005

RESUMO

The presence of intralesional fat provides an invaluable tool for narrowing the differential diagnosis for both benign and malignant neoplasms of the abdomen and pelvis. The ability to characterize intralesional fat is further expanded by the ability of magnetic resonance imaging to detect small quantities (intravoxel) of fat. The differential diagnosis of fat-containing lesions arising in the liver is broader than that of many other solid organs. However, this differential can be further refined depending on the type of fat (macroscopic vs intravoxel) and with the use of ancillary imaging findings. Radiologists must be aware of benign and malignant mimickers of common lesions.


Assuntos
Fígado Gorduroso/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Equinococose Hepática/diagnóstico por imagem , Humanos , Lipomatose/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X
4.
Rev Soc Bras Med Trop ; 53: e20180046, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994653

RESUMO

Hepatopulmonary hydatidosis in young children is a rare and atypical presentation of Echinococcus granulosus infection. We report the first case of cystic echinococcosis caused by a microvariant of E. granulosus sensu stricto. Chemotherapy and systemic corticoids were administered before curative surgery was performed. Recurrence was not observed for more than 24 months of follow-up.


Assuntos
Albendazol/administração & dosagem , Equinococose Hepática/diagnóstico por imagem , Equinococose Pulmonar/diagnóstico por imagem , Echinococcus granulosus/isolamento & purificação , Animais , Pré-Escolar , Equinococose Hepática/terapia , Equinococose Pulmonar/terapia , Feminino , Seguimentos , Humanos , Toracoscopia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Z Gastroenterol ; 58(1): 63-67, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31931542

RESUMO

We report the case of a 65-year-old female patient with hepatic alveolar echinococcosis (AE) caused by Echinococcus multilocularis. This infrequent zoonosis has a considerable morbidity and mortality. The malignant appearing hepatic mass was initially misdiagnosed as cholangiocarcinoma of the right hepatic lobe (segments VII, VIII, and IVa, sized 10.9 cm × 7.6 cm) involving the right and middle hepatic vein and extending close to the left hepatic vein. During exploratory laparotomy, the frozen-section biopsy was indicative of AE (World Health Organization [WHO] classification: stage P3N0M0). Due to the high operative risk, it was decided to pretreat the patient with albendazole as inductive therapy in order to remove the AE secondarily in accordance with the patient's request. After year-long treatment with albendazole (under strict control of the maximum blood levels), a right hemihepatectomy was successfully performed. Postoperative treatment with albendazole had to be stopped prematurely after 11 months due to considerable subjective intolerance and a more-than-tenfold elevation of transaminases despite normal therapeutic albendazole blood levels. A 18F-FDG-PET/CT scan revealed no evidence of AE residues. Conducting follow-up examinations by 18F-FDG-PET/CT scans every 2 years is planned in order to recognize possible recurrence at an early stage.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Equinococose Hepática/terapia , Echinococcus multilocularis/isolamento & purificação , Tomografia por Emissão de Pósitrons/métodos , Idoso , Animais , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/parasitologia , Echinococcus multilocularis/efeitos dos fármacos , Feminino , Fluordesoxiglucose F18 , Hepatectomia , Humanos , Recidiva Local de Neoplasia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Resultado do Tratamento
6.
Turkiye Parazitol Derg ; 43(4): 175-181, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31865652

RESUMO

Objective: Hydatidosis is a zoonotic parasitic infection caused by the larval stage of Echinococcus granulosus. The aim of this study was to investigate the biochemical structures of germinal membrane and cyst fluids obtained from patients with liver involvement during surgery, by Raman spectroscopy at the molecular level. Methods: Molecular characterization of germinal membrane and cyst fluid according to mitochondrial gene region was determined and phylogenetic analysis was performed. Raman spectroscopy was used in samples and spectral bands between 300 and 1800 cm-1 were examined. Results: As a result of PCR, approximately 400 bp DNA band was obtained from germinal membranes and cyst fluids gathered from patients. Peaks were observed at 780, 880, 970, 1151, 1200, 1270 cm-1 for germinal membrane and at 780 and 1200 cm-1 for cyst fluid. The highest spectral bands were obtained at 1333-1335 cm-1 and were determined to be modes indicating the CH3CH2 collagen and polynucleotide chain. Conclusion: In the identification of microorganisms and biochemical analysis of biological tissues; different diagnostic methods such as molecular, serological and conventional methods are used. In addition to these methods, Raman spectroscopy has been shown in studies to be a fast, non-destructive and noninvasive method. Therefore, it is thought to be an alternative method for analyzing the basic biochemical components of microorganisms at molecular level.


Assuntos
Equinococose Hepática/diagnóstico por imagem , Echinococcus granulosus/classificação , Zoonoses/diagnóstico por imagem , Animais , Líquido Cístico/química , DNA de Helmintos/química , Equinococose Hepática/parasitologia , Echinococcus granulosus/genética , Complexo IV da Cadeia de Transporte de Elétrons/genética , Humanos , Mitocôndrias/enzimologia , Filogenia , Reação em Cadeia da Polimerase , Análise Espectral Raman , Zoonoses/parasitologia
7.
Parasite ; 26: 54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31469072

RESUMO

BACKGROUND: Alveolar echinococcosis (AE) is a rare zoonosis caused by the larval stage of the tapeworm Echinococcus multilocularis. AE lesions affect the liver in more than 98% of cases. AE lesions have various morphological characteristics that are described in the Echinococcus multilocularis Ulm classification for computed tomography (EMUC-CT). One of these characteristics is a cystoid portion. The aim of the study was to compare the density of simple hepatic cysts with cystoid portions of AE lesions classified on the basis of the EMUC-CT. RESULTS: Hounsfield Unit (HU) measurements of the cystoid portions of all EMUC-CT type I-IV AE lesions (n = 155) gave a mean of 21.8 ± 17.6, which was significantly different from that of 2.9 ± 4.5 for the simple hepatic cysts (p < 0.0001). The difference between each of the individual AE types and simple hepatic cysts was also significant. In addition, the HU values of the cystoid portions in types I, II and IIIa/b and simple cysts were each significantly different from type IV (p < 0.0001). The HU measurements in type IV presented by far the highest mean. CONCLUSIONS: The significantly higher density measured in the cystoid portions of hepatic AE lesions offers a good means of differentiation from simple hepatic cysts.


Assuntos
Equinococose Hepática/fisiopatologia , Fígado/patologia , Fígado/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Equinococose Hepática/diagnóstico por imagem , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
8.
J Helminthol ; 94: e80, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31466533

RESUMO

The co-occurrence of hepatic cystic echinococcosis (CE) and alveolar echinococcosis (AE) is extremely rare. Here, we present the clinical manifestations and treatment outcomes of three cases with co-occurring CE and AE in the liver. Computed tomography (CT), magnetic resonance imaging and 18FFluorodeoxyglucose Positron Emission Tomography-CT were used for preoperative diagnosis. Specimens were taken intraoperatively and sent for pathological studies to confirm the coexistence of CE and AE by laminated membrane, daughter cysts or germinal layer and infiltration structure. Albendazole was prescribed after operation for 12 months. All patients were completely recovered and showed no recurrence at last follow-up. Therefore, surgical intervention and postoperative application of albendazole are recommended for patients with concurrence of hepatic AE and CE.


Assuntos
Equinococose Hepática/diagnóstico por imagem , Equinococose/diagnóstico por imagem , Fígado/parasitologia , Adolescente , Adulto , Equinococose/tratamento farmacológico , Equinococose Hepática/tratamento farmacológico , Feminino , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Resultado do Tratamento
9.
BMC Infect Dis ; 19(1): 661, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340769

RESUMO

BACKGROUND: Echinococcosis multilocularis (Hydatid Disease - HD) is a zoonotic disease caused by the larval form of Echinococcus multilocularis (EM). The main sites for this zoonosis are the Middle East, China, India, Alaska, and Siberia. It is rather rare in Europe. In Poland, the Warmian-Masurian Province is the endemic region for Echinococcus multilocularis. The clinical manifestation of the disease is dependent on the location, the size of the cyst and the development stage of the parasite. Considering the uncommon character of echinococcosis in Central Europe, especially such located in the areas outside the liver and lungs, the authors would like to present a case of coexistence in one patient of two EM foci in the liver and the head of the pancreas. CASE PRESENTATION: We present a clinical case of a 32-year-old man who was diagnosed with a cystic lesion with septa and calcification in the sixth segment of the liver and a suspicious change in the head of the pancreas. ELISA Em 2 plus test was positive, Western Blot method - the P-5 pattern showed an image that is characteristic of an EM infection. The sixth liver segment with a tumour and a tumour from the head of pancreas were excised by means of laparotomy. On the 6th day after the surgery the patient was discharged from hospital without complications and in good condition. Currently, he is under the control of a parasitic and zoonotic clinic. He takes an 800 mg daily dosage of Albendazole. CONCLUSIONS: The presented clinical case shows that if we have a patient with cystic / tumour change in the pancreas and positive immunological tests, CT and MRI of the abdominal cavity are usually sufficient in order to fully diagnose and to qualify such a person for surgery. The most effective treatment is surgical treatment supplemented with pre- and postsurgical treatment with Albendazole.


Assuntos
Equinococose Hepática/parasitologia , Echinococcus multilocularis/isolamento & purificação , Fígado/parasitologia , Pâncreas/parasitologia , Adulto , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/tratamento farmacológico , Echinococcus multilocularis/genética , Echinococcus multilocularis/crescimento & desenvolvimento , Humanos , Imagem por Ressonância Magnética , Masculino
10.
BMC Gastroenterol ; 19(1): 103, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234803

RESUMO

BACKGROUND: Biliary mucinous cystic neoplasms are rare cystic lesions of the liver which carry pre-malignant potential. Given the scarcity of reports in the literature, they pose a considerable challenge to clinical management, particularly with regards to accurate pre-operative diagnosis. CASE PRESENTATION: We present the case of a 37-year-old Tunisian woman who presented with subacute right upper quadrant pain and a large multi-loculated cystic lesion, most consistent with a hydatid cyst. She underwent an open right hepatectomy, and pathology surprisingly revealed a biliary mucinous cystadenoma. Herein, we review the current literature on biliary mucinous cystic neoplasms, with a particular emphasis on diagnostic investigations, key radiological features and optimal treatment modalities. CONCLUSION: Biliary mucinous cystic neoplasms require a high index of suspicion and should be managed with complete surgical resection, as conservative techniques are associated with high recurrence rates. Considering the potential for malignant transformation, periodical surveillance imaging is recommended in the post-operative period.


Assuntos
Cistadenoma Mucinoso/diagnóstico , Equinococose Hepática/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico , Adulto , Cistadenoma Mucinoso/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hepáticas/cirurgia , Tomografia Computadorizada por Raios X
14.
Adv Med Sci ; 64(2): 324-330, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31003201

RESUMO

PURPOSE: Hepatic alveolar echinococcosis (AE) is a parasitic disease caused by the larval stage of the tapeworm Echinococcus multilocularis. Ultrasonography is the method of choice in the initial diagnosis of AE. The aim of the study is to present the most frequent sonomorphological patterns of lesions in hepatic AE based on the analysis of ultrasound findings in patients treated for AE at the University Centre of Maritime and Tropical Medicine (UCMMiT; Gdynia, Poland), and to establish whether there is a relationship between the clinical stage of AE and the occurrence of a specific sonomorphological pattern of hepatic lesions. PATIENTS AND METHODS: We analysed the results of ultrasound examinations of 58 patients hospitalized in the UCMMiT with probable or certain diagnosis of AE. Liver lesions were assessed according to the classification developed by researchers from the University Hospital in Ulm (Germany). Statistical analysis was based on the relationship between the occurrence of a specific sonomorphological pattern of hepatic lesions and the clinical stage of AE. RESULTS: The most frequently observed patterns of AE lesions in the liver were the hailstorm and the pseudocystic patterns. There was no correlation between the clinical stage of the disease and the ultrasonographic appearance of lesions. There was no statistically significant relationship between the more frequent occurrences of specific ultrasonographic patterns of lesions in the liver and radical or non-radical surgery. CONCLUSIONS: The ultrasonographic appearance of the lesion in liver AE cannot determine the therapeutic management. Treatment plan should be established based on the PMN classification.


Assuntos
Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/patologia , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 30(6): 674-677, 2019 Feb 21.
Artigo em Chinês | MEDLINE | ID: mdl-30891983

RESUMO

OBJECTIVE: To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. METHODS: Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People's Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. RESULTS: Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was -28 to -84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient's cyst was complicated with infection and it invaded the abdominal wall. CONCLUSIONS: The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.


Assuntos
Equinococose Hepática , Equinococose , Diagnóstico Diferencial , Equinococose/diagnóstico por imagem , Equinococose Hepática/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
18.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 30(6): 678-681, 2019 Feb 20.
Artigo em Chinês | MEDLINE | ID: mdl-30891984

RESUMO

OBJECTIVE: To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. METHODS: Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. RESULTS: The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . CONCLUSIONS: The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.


Assuntos
Equinococose Hepática , Imagem de Perfusão , Tomografia Computadorizada por Raios X , Equinococose Hepática/diagnóstico por imagem , Humanos , Perfusão , Reprodutibilidade dos Testes
20.
Medicine (Baltimore) ; 98(8): e14561, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30813170

RESUMO

RATIONALE: A characteristic metabolic finding of hepatic alveolar echinococcosis (HAE) on positron emission tomography/computed tomography (PET/CT) correlates with morphologic features on CT and magnetic resonance imaging (MRI). PATIENT CONCERNS: A young man from an endemic area was admitted to our hospital due to right upper quadrant pain for 2 months. DIAGNOSIS: CT and MRI revealed a heterogeneous mass with calcification, consisting of central necrosis and peripheral solid inflammatory tissues. Accordingly, FDG PET/CT demonstrated a characteristic metabolic finding of doughnut sign. Combining the above characteristic imaging features with positive serologic findings, the patient was diagnosed as HAE. INTERVENTIONS: He then underwent extracorporeal hepatectomy and liver autotransplantation followed by medical treatment of benzimidazoles. OUTCOMES: He remained asymptomatic without evidence of recurrence at 2-year follow-up. LESSONS: The characteristic metabolic appearance of HAE on FDG PET/CT, correlated with its morphologic features of CT and MRI, may allow to make accurate diagnoses.


Assuntos
Equinococose Hepática/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Animais , Antiparasitários/uso terapêutico , Benzimidazóis/uso terapêutico , Equinococose Hepática/terapia , Echinococcus granulosus , Fluordesoxiglucose F18/metabolismo , Hepatectomia/métodos , Humanos , Fígado/diagnóstico por imagem , Fígado/parasitologia , Transplante de Fígado/métodos , Masculino , Transplante Autólogo/métodos , Adulto Jovem
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