Computerized tomographic findings of hepatic fascioliasis compared with melioidosis-caused liver abscesses.

Abstract

OBJECTIVE:

To compare the computerized tomographic (CT) findings of hepatic fascioliasis (HF) vs. melioidosis-caused liver (ML) abscesses.

MATERIAL AND METHOD:

CT images of 15 patients with hepatic fascioliasis (HF) and 16 patients with melioidosis-caused liver (ML) abscesses were retrospectively reviewed. The authors evaluated and compared HF and ML abscesses (by chi2 and Fisher exact tests) vis-a-vis their location of liver involvement, size, shape, number margins, enhancement patterns, subcapsular lesions, internal architecture, dilatation of intrahepatic bile duct and combination with splenic abscesses.

RESULTS:

Fourteen HF patients had only liver abscesses and 1 had combined liver and splenic abscesses. Four ML patients had liver abscesses alone while 12 had combined liver and splenic abscesses (p = 0.000). Eight of the 15 HF (53.3%) and 2 of the 16 ML (12.5%) patients had subcapsular lesions (p = 0.019). The liver abscesses were round or oval with linear tracts in 8 of the 15 HF (53.3%) and none of the ML patients (p = 0.001). Between the respective HF and ML patients, there was a significant difference in those with round shaped in ML (p = 0.008), multiple and conglomerately distributed in HF (p = 0.050), multiple and discretely distributed in ML (p = 0.001) no (or minimal) peripheral contrast enhancement in HF (p = 0.011) and moderate or mark peripheral enhancement in ML (p = 0.011).

CONCLUSION:

The CT findings of liver abscesses that helped to differentiate hepatic fascioliasis from melioidosis liver abscesses were: their number shape, enhancement pattern, presence of subcapsular lesion (s) and co-occurrence with splenic abscesses. The diagnosis of hepatic fascioliasis by CT is suggested when the following characteristics were seen: (1) multiple, small round or oval (with linear tracts) conglomerates presenting as hypodense lesions; (2) no (or minimal) peripheral contrast enhancement; (3) subcapsular lesions; or (4) less frequent co-occurrence with splenic abscesses.

• Authors: Nittaya Chamadol, Vallop Laopaiboon, Pennapa Techasatian, Wattana Sukeepaisanjaroen, Anan Sripanuskul
• Journal: Journal of the Medical Association of Thailand = Chotmaihet thangphaet (J Med Assoc Thai) Vol. 93 Issue 7 Pg. 838-48 (Jul 2010) ISSN: 0125-2208 [Print] Thailand
• PMID: 20649065 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Animals
• Burkholderia pseudomallei (isolation & purification)
• Fasciola hepatica (isolation & purification)
• Fascioliasis (diagnostic imaging, microbiology)
• Female
• Humans
• Liver Abscess (diagnostic imaging, microbiology)
• Male
• Melioidosis (diagnostic imaging, microbiology)
• Middle Aged
• Retrospective Studies
• Splenic Diseases (diagnostic imaging, microbiology)
• Tomography, X-Ray Computed
• Young Adult