The imaging features, clinical diagnosis value of fulminant hepatic fasciola gigantica disease / 实用放射学杂志

ABSTRACT

Objective To investigate the clinical manifestations and imaging modality for the diagnosis of hepatic fasciola gigantica disease.Methods Thirty eight patients with abdominal pain were admitted in our hospital and underwent investigations with different imaging modalities.Thirty-eight cases underwent abdominal CT scan,among which 5 cases underwent follow-up with abdominal ultrasonography,10 patients with routine MRI scan and CT scan examination,and 2 cases with liver biopsy.Results Thirty-eight cases with CT scan showed the hepatomegaly,with decreased attenuation of the hepatic parenchyma,unclear boundaries.Thirteen cases showed decreased densities (suggesting hydroperitonium),including 10 cases with enhanced CT showed mild inhomogenous enhancement.Five cases with color doppler ultrasound showed inhomogenous hepatic echogenicity,and multiple liver parenchyma echogenecity showedirregular,cluttered cystic dark areas and spleenomegaly,among which two cases had evident hydroperitonium.Ten cases with MRI scan showed liver enlargement,abnormal diffuse signal of hepatic parenchymal lesions and splenomegaly.Two cases who underwent needle biopsy showed parasitic granulomas and necrosis,surrounded by a large number of monocytes andeosinophilic infiltration.Clinical manifestationsAll cases were presented with fever,abdominal pain,liver tenderness,etc.Twenty-five cases presented with nausea,vomiting,loss of appetite,15 cases presented with ascites,5 cases presented with pericardial effusion,5 cases with lung parenchymal changes on CT,others showed generalised systemic edema and malena,very few patients had utricaria,itching and other symptoms.Conclusion CT and MRI scanning in patients suspected with human fasciola hepatica showed multiple small hepatic subcapsular abscess,of which some were clustered or tunnel-like.Combined with parasites,imaging manifestations are helpful for the early diagnosis.