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Pictorial essay


Radiological Imaging Features of Fasciola hepatica Infection - A Pictorial Review

Abdurrahim DusakMehmet R OnurMutalip CicekUgur FiratTianbo RenVikram S Dogra
Department of Radiology, University of Rochester Medical Center, Rochester, NY, US, Department of Microbiology,Department of Pathology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
Date of Submission: 07-Nov-2011, Date of Acceptance: 01-Jan-2012, Date of Web Publication: 27-Jan-2012.
Corresponding Author:
Corresponding Author

Abdurrahim Dusak

601 Elmwood Avenue, 14642, Rochester, NY, US.
E-mail: adusak@yahoo.com

Corresponding Author:
Corresponding Author

Abdurrahim Dusak

601 Elmwood Avenue, 14642, Rochester, NY, US.
E-mail: adusak@yahoo.com

DOI: 10.4103/2156-7514.92372 Facebook Twitter Google Linkedin

ABSTRACT


Fascioliasis refers to a zoonosis caused by Fasciola hepatica, a trematode infecting herbivores, but also occurs in humans who ingest the metacercaria found in fresh water plants. Infection in humans is common in developing countries and is also not uncommon in Europe. Diagnosis of this infection is difficult, as the history and symptoms are nonspecific and stool analysis for eggs is negative until the disease is in an advanced state by when the parasite has reached the biliary system. The clinical course consists of two phases; first a hepatic parenchymal phase in which immature larvae invade the liver parenchyma, followed by a ductal phase characterized by the excretion of larvae into the bile ducts. Parenchymal Phase: Ultrasonography (US) findings are nonspecific in this early phase. Computerized tomography (CT) may demonstrate subcapsular low attenuation regions in the liver. Magnetic Resonance imaging (MRI) can also be utilized to establish liver parenchymal involvement, and is better than CT in characterizing hemorrhagic lesions, as well as identifying more lesions relative to CT. Ductal Phase: US examination is most useful at this stage, with its ability to demonstrate the live movement of the worms within the dilated ducts. A CT demonstrates dilated central biliary ducts with periportal tracking, whereas, mild ductal dilatation is poorly appreciated under MRI. Therefore, familiarity with the multimodality imaging features of fascioliasis, in combination with an available confirmatory enzyme-linked immunoassay, would be most helpful for early diagnosis.
Keywords: Fasciola Hepatica, Fascioliasis, Amoebic Abscess, Hydatid Disease, Pyogenic Abscess, Radiological Imaging Features

Cited in 25 Documents

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