Imaging Findings of Liver Clonorchiasis I-Hao Su Sung-Yu CHu CHIen-MIng CHen Kuang-TSe Pan MIng-YI HSu Ren-Fu SHI Jeng-HweI TSeng

The objective of this study was to analyze the hepatic imaging findings concerning clinical data on clonorchiasis. From August 1994 to September 2009, 13 patients were diagnosed with hepatic clonorchiasis by identification of adult flukes in the biliary tract through biliary drainage and/or surgery at a single institution. We analyzed their medical records and imaging findings by cholangiography and computed tomography (CT). The 13 enrolled patients were all men ranging in age from 44 to 80 years (mean ± standard deviation, 62.1 ± 10.0 years). The most common admission diagnosis was biliary tract infection (84.6%). Cholangitis and cholecystitis were the two most common biliary diseases of the enrolled patients (92.3%), followed by biliary lithiasis (46.2%). Five hepatopancreatobiliary tumors were detected, including three cholangiocarcinomas, one pancreatic head cancer, and one hepatocellular carcinoma. The patient who had pancreatic head cancer also had swollen duodenal papilla, chronic inflammation of the ampulla of Vater, and pancreatitis. Diffuse, pipelike, mild dilatation of peripheral intrahepatic ducts up to the subcapsular region of the liver was the most common finding on cholangiography and CT (76.9%), followed by uniform, leaflike, filamentous, tiny intraductal filling defects (69.2% on cholangiography and 61.5% on CT) and biliary lithiasis (46.2% on cholangiography and 38.5% on CT). The diagnosis of clonorchiasis is often delayed, and it is usually identified incidentally by biliary drainage or surgery in symptomatic patients with high parasite burdens. The characteristic imaging findings with a history of raw freshwater fish consumption and the presence of hepatobiliary symptoms can help the physician to suspect or diagnose clonorchiasis. Correspondence Author to: Chien-Fu Hung Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine,