Case series of visceral larva migrans in the liver: CT and MRI findings

Introduction: Visceral larva migrans (VLM) is an uncommon parasitic infection most commonly caused by Toxocara canis and Toxocara cati. Imaging features of hepatic VLM on contrast enhanced computed tomography (CECT) include presence of small, single or multiple (usually less than two cms in diameter) hypovascular eosinophilic abscesses seen enhancing only on portal venous phase (PVP) on triple phase liver study. Review of literature revealed that CT and peripheral eosinophilia in the blood has been the mainstay of clinical diagnosis in majority of case reports and larger studies. Case Series: We have used 3 Tesla (3T) magnetic resonance imaging (MRI) in addition to CT for diagnosis of hepatic visceral larva migrans in three patients with special emphasis on T1 weighted and diffusion weighted sequences. MRI and CT images showed interesting findings such as hyperintense rim of the lesions on T1 weighted sequence and hyperintensity on diffusion weighted images (DWI) at b values of 1000 with associated restriction on the corresponding ADC maps. Conclusion: We would like to emphasize the importance of echo planar imaging and T1 weighted sequences of the liver in addition to routine dynamic CT and conventional MRI sequences for assessment of suspected eosinophilic abscesses in visceral larva migrans presenting as focal liver lesions