Ultrasonic and X-ray tomographic findings of schistosomiasis japonicum.

Imaging diagnosis based on ultrasonic findings of the liver with Schistosomiasis Japonica has been recently reported (Nakayama et al. 1981 Uto et al. 1984). In the present study, attempts were made to classify the ultrasonic patterns of the liver infected with Schistosoma Japonicum. The calcification and fibrosis of the liver were evaluated by comparative investigation with an ultrasonogram and computed tomography (CT). Schistosomiasis Japonica was examined in 23 patients who were more than 45 years of age. It was diagnosed by liver needle biopsy, an intracutaneous test, or autopsy. The cases with a fish scale and network pattern had attenuation of the liver on ultrasonography and were unspecific on CT. Histological findings demonstrated moderate liver fibrosis. The cases with a sieve pattern had attenuation on ultrasonography, and the CT disclosed a retractive liver and the CT number of that liver was increased. Histological findings demonstrated a severe f ibrotic liver. The cases with a mottled pattern had increased reflective spotty echo with an acoustic shadow, and the CT disclosed calcification. The histological findings demonstrated a marked calcification of the eggs. The cases with a mixed pattern, which consisted of mottled and sieve based on fish scale and network, had no retraction with less increase in the CT number. These results suggest that the peculiar reflective echo pattern of Schistosomiasis Japonica was due to not only calcification but also fibrosis of the liver.