• Title/Summary/Keyword: periductal echogenicity

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Long-lasting sonographic and histopathological findings in cured clonorchiasis of rabbits

  • Choi, Dong-Il;Lim, Jae-Hoon;Kim, Seung-Kwon;Kim, Eung-Yeop;Lee, Me-Jeong;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.37 no.2
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    • pp.77-83
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    • 1999
  • To ascertain residual sonographic and histopathological findings of clonorchiasis after treatment, the present study evaluated sonographic findings in rabbits which were infected with 500 metacercariae of C.sinensis every 6 months for 18 months after treatment with praziquantel. The sonographic findings were analyzed in terms of intrahepatic bile duct dilatation and periductal echogenicity, and histopathological findings were observed after the last sonographic examination. Compared with the sonographic findings before treatment, dilatation of the intrahepatic bile ducts became mild to some degree in four of the seven cases and increased periductal echogenicity resolved in four of them. The histopathological specimens after 18 months showed that periductal inflammation has almost resolved but moderate dilatation of the intrahepatic ducts and mucosal hyperplasia persisted. The periductal fibrosis minimally resolved. The log-lasting sonographic findings in cured clonorchiasis make sonography less specific.

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Imaging diagnosis of clonorchiasis

  • Choi, Don-Gil;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.45 no.2 s.142
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    • pp.77-85
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    • 2007
  • Among several diagnostic tools for clonorchiasis (Clonorchis sinensis infection), radiologic examinations are commonly used in clinical practices. During the 2 past decades, many reports regarding imaging findings of clonorchiasis were introduced. The basic imaging finding of clonorchiasis is diffuse dilatation of the peripheral intra-hepatic bile ducts, without dilation of the large intrahepatic or extrahepatic bile ducts. By this finding, however, active clonorchiasis cannot be differentiated from cured infection. Some recent radiologic studies suggested specific findings of active clonorchiasis. Besides direct demonstration of worms, increased periductal echogenicity on sonography and periductal enhancement on dynamic contrast-enhanced CT or MR imaging possibly represent active clonorchiasis. Those images of the liver clonorchiasis are known to be correlated with worm burdens (EPG counts) in their frequency and also severity. The images of cholangiocarcinoma associated with clonorchiasis show both the tumor with obstruction images and diffuse dilatation of the peripheral intrahepatic bile ducts. Radiological images can be a good practical alternative diagnostic method of clonorchiasis.

Evaluation of sonography and skin test in diagnosis of clonorchiasis at the Hyongsan-gang (River) area (형산강 유역 포항 통합시 근로자들에 있어서 간흡충 감염상 및 초음파검사와 피내반응검사의 정확도)

  • 이현경
    • Parasites, Hosts and Diseases
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    • v.33 no.2
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    • pp.117-124
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    • 1995
  • This study was performed to evaluate diagnostic sensitivity and specificity of sonography on clonorchiasis. During the 9 months from March to November 1994, sonography skin test, stool examination, and medical examination were performed to 609 volunteers of Pohang which is located along the Hyongsan-gang (Rivers and is one of well-known endemic areas of clonorchiasis. The sensitivity of sonography was either 21% if the intrahepatic ducts dilatation was assumed to be the only positive anding or 52% if the periductal echogenicity was also included as one of positive findings. The sensitivity of skin test was 62%. The sensitivity was 46% if the diagnostic criteria were arbitrarily assumed as being positive in skin test and having either sonographic findings. The sonographic finding of fusiform, non-shadowing, weakly echogenic foci in gallbladder or in billiaiy tree indicating the flukes or aggregates of flukes was not obvious in this study. The specificity of sonography was either 95% if the intrahepatic ducts dilatation was assumed to be the only positive finding or 82% if the periductal echogenicity was also included as one of positive findings. The specificity of skin test was 52%. The specificity was 90% if the diagnostic criteria was arbitrarily assumed as being positive in skin test and having either sonographic findings.

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Changes in Sonographic Findings after Treatment of Patients with Clonorchiasis in a Heavy Endemic Area

  • Choi, Dong-Il;Jeon, Yong-Hwan;Lee, Geun-Chan;Choi, Min-Ho;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.47 no.1
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    • pp.19-23
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    • 2009
  • We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) as observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.

Painless Jaundice Caused by Clonorchis sinensis Infection: A Case Report

  • Hao, Yuhua;Bao, Wanguo;Jin, Meishan;Li, Yuxiang;Wang, Feng
    • Parasites, Hosts and Diseases
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    • v.54 no.3
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    • pp.323-327
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    • 2016
  • A man with only yellowing of the skin and eye sclera was diagnosed with clonorchiasis, which rarely manifested jaundice as the initial symptom. However, because of a lack of evidence for a diagnostic gold standard, the time until definitive diagnosis was more than a week. The diagnostic process relied on inquiring about the patient's history, including the place of residence, dietary habits, and symptoms, as well as on serological findings, an imaging examination, and pathological findings. MRCP and CT results showed mild dilatation of intrahepatic ducts and increased periductal echogenicity. The eggs were ultimately found in stool by water sedimentation method after the negative report through direct smear. DNA sequencing of PCR production of the eggs demonstrated 98-100% homology with ITS2 of Clonorchis sinensis. After anti-parasite medical treatment, the patient's symptoms were gradually relieved. Throughout the diagnostic procedure, besides routine examinations, the sedimentation method or concentration method could be used as a sensitive way for both light and heavy C. sinensis infection in the definite diagnosis.