Korean J Radiol.  2004 Mar;5(1):25-30. 10.3348/kjr.2004.5.1.25.

MR Imaging Findings of Clonorchiasis

• Jeong YY
• Kang HK
• Kim JW
• Yoon W
• Chung TW
• Ko SW

• KMID: 1066242
• DOI: http://doi.org/10.3348/kjr.2004.5.1.25

Abstract

OBJECTIVE
The purpose of this study was to evaluate the MR spectrum and MR cholangiographic imaging findings of clonorchiasis. MATERIALS AND METHODS: We reviewed 26 patients with confirmed clonorchiasis by either stool tests (n=24) or surgery (n=2). MR imaging was performed on a 1.5 T system (GE Medical Systems, Milwaukee, WI) with a torso coil. Axial T1-and T2-weighted, gadolinium-enhanced dynamic images and MR cholangiography were obtained. Image analyses were used to identify abnormalities of the intrahepatic and extrahepatic bile ducts and the presence of hepatobiliary malignancy. All MR examinations were reviewed by the consensus of two abdominal radiologists. RESULT: Intrahepatic bile duct abnormalities were seen in 23 (89%) of the 26 patients. The most common finding was mild dilatation of the intrahepatic bile duct which was found in 21 (81%). "Too many intrahepatic ducts" were found in 16 (62%), wall enhancement and thickening in 21 (81%) and filling defects and ductal stricture in the intrahepatic bile duct in 6 (24%) and 3 (12%) patients, respectively. Extrahepatic ductal dilation was found in 5 (19%) and 9 (35%) revealed hepatobiliary malignancy. CONCLUSION: MR imaging revealed various findings of clonorchiasis, including dilatation, wall enhancement, stricture of the intrahepatic ducts and filling defect within the intrahepatic bile duct.

Keyword

Bile ducts, diseases; Bile ducts, cholangitis; Magnetic resonance (MR), cholangiopancreatography; Bile ducts, MR

MeSH Terms

Adult
Aged
Cholangiography/methods
Clonorchiasis/*diagnosis/radiography
Female
Human
*Magnetic Resonance Imaging/methods
Male
Middle Aged

Figure

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  Fig. 1 Clonorchiasis in a 49-year-old man. Coronal single-shot fast spin echo MR cholangiogram (TR/effective TE=∞/800, 40-mm section thickness) shows too many intrahepatic bile ducts, without dilatation of extrahepatic bile duct. Focal stricture (arrow) is seen in the left intrahepatic bile duct.

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  Fig. 2 Clonorchiasis in a 58-year-old man. Gadolinium-enhanced echo fast gradient echo 3D (TR/TE, 7/2) transverse (A) and coronal (B) images show periductal enhancement of mildly dilated intrahepatic bile duct (arrows). There is no dilatation of extrahepatic bile duct.

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  Fig. 3 Clonorchiasis in a 58-year-old man. A. Transverse T2-weighted single shot fast spin-echo image (TR/effective TE=∞/92) shows elliptical filling defects (arrows) in a dilated intrahepatic bile duct. B. Oblique coronal single-shot fast spin-echo MR cholangiogram (TR/effective TE=∞/800, 40-mm section thickness) shows multiple small, ovoid or elliptical shaped, filling defects (arrows) in both the intrahepatic bile ducts. MR cholangiogram more clearly demonstrates the diffuse, mild dilatation of the small intrahepatic bile ducts than in theT2-weighted image (A).

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  Fig. 4 Clonorchiasis, with a common bile duct carcinoma, in a 75-year-old man. A. Coronal single-shot fast spin-echo MR cholangiogram (TR/effective TE=∞/800, 40-mm section thickness) shows abrupt obstruction of the proximal common bile duct (arrow) with marked dilatation of the intrahepatic bile duct. B. Gadolinium-enhanced echo fast gradient echo 3D (TR/TE, 7/2) image at the level of obstruction shows thickened, an enhanced wall of the proximal common bile duct (arrows), suggestive of a cholangiocarcinoma.

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