Imaging of liver fascioliasis in children.

Petrash E.A., Mikhaylova E.V., Sergeeva O.N., Nikulina A.L., Sevrukov D.D., Shelankova A.V.

Fascioliasis is an unusual pediatric zoonotic disease in European countries. Due to awareness of the disease, patients admit to oncological clinics with suspicion for liver tumors. Clinical presentation of fascioliasis is nonspecific, visualization methods and serological tests are much more important for the diagnosis. The aim of the study was to describe ultrasound and MRI findings in three children with suspected liver tumors, in whom diagnoses were changed to fascioliasis after additional examination. Materials and methods. Liver ultrasound reveals multiple small round non-vascular hyper- and hypoechoic lesions ranging from 5 to 12 mm in diameter within hepatic parenchyma. All children demonstrate moderate bile duct dilatation with biliary and gall-gladder wall thickening. Capsular hyperintensity, multiple hyperintense on T2-weighted im-ages (WI) spiral structures with hypointense rim, iso- and hypointense on T1WI with hyperin-tense rim and diffusion restriction, and area of increased signal on T2WI were demonstrated in all cases. Thickening of the walls of the ducts and gallbladder, parasites within the bile ducts were observed. One patient also had pancreatic and brain lesions. Conclusion. Diffuse heterogenic liver lesions are specific for parenchymal phase on US. Typical for parenchymal phase MRI-findings include capsular hyperintensity, multiple spiral hyperintensive on T2-weighted images (WI) liver lesions. Both US and MRI show dilata-tion and deformation of the bile ducts and thickening of gallbladder wall in ductal phase. In some cases parasites can be detected in the lumen of the gallbladder and bile ducts. It is necessary to keep in mind that fascioliasis can invade other organs except liver.

1 - Radiology department of Research Institute of Children's Oncology and Hematology. N.N. Blokhin National Medical Research Center of Oncology.

2 - Laboratory of Interventional Radiology of Research Institute of Clinical and Experimental Radiology. N.N. Blokhin National Medical Research Center of Oncology.

3 - Department of retina and optic nerve pathology, Scientific Research Institute of eye diseases. Moscow, Russia.

Keywords: fascioliasis, infections, liver, bile ducts, ultrasound, MRI, hepatobiliary, focal liver lesions.

Corresponding author:  Petrash E.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Petrash E.A., Mikhaylova E.V., Sergeeva O.N., Nikulina A.L., Sevrukov D.D., Shelankova A.V. Imaging of liver fascioliasis in children. REJR 2018; 8 (3):296-304. DOI:10.21569/2222-7415-2018-8-3-296-304.


Received:        28.09.18                           Accepted:       10.10.18