TỔN THƯƠNG ĐẶC TRƯNG HỆ GAN MẬT DO SÁN LÁ GAN LỚN FASCIOLA GIGANTICA Ở NGƯỜI QUA CHẨN ĐOÁN HÌNH ẢNH

Abstract

The aim of the study: To describe the sonographic findings of human hepatobiliary fasciolias.

Subjects and methods: With cross-sectional study design, all diagnoses were confirmed cases, sonographic and/or CT-scan, MRI findings in the hepatobiliary system were defined.

Results: Total of 1.020 fascioliasis case, 97.25% hepatobiliary lesions. The most common hepatic lesions were subcapsular localized, confluent, multiple hypoechoic nodules with poorly defined borders (88.4%), subcapsular like-hematoma (3.53%) and the biliary tract (7%); the lesions of right liver (80.28%) were much more than left ones; predominantly in liver sublobe V, VI, VII, and VIII of 80.28%; number of lesion foci were 1 or 2 (86.32% and 12.09%); diameter of foci arounded 5 - < 7 cm (53.14%); characters and sound-back features of lesions were mainly heterogenous parenchyma (96.27%), hypoechoic lesions (83.12%) and mixed-echo lesions (59.86%). In the chronic phase, typical sonographic findings were multiple sites of floating or mobile echogenic trace in gallbladder or biliary duct without posterior shadow (1.84%). There were thick wall of gallbladder and biliary tract (2.52% and 2.85%), coincident abnormals of both liver and biliary tracts (1.18%). On the CT-scan, hypointensive, clusted oval or round images (78.57%), hypointensive near liver capsule (16.23%), thickening Glisson capsular (7.14%), dilated bile duct with fasciola trace (5.84%), fibrosis scar (11.04%). On the MRI, parenchyma hyperintense via axial and temporal slice (20.93%), especially in hyperintense on T2W images (96.51%), fibrose scar under capsular (30.23%).

Conclusions: Ultrasonography is a useful tool to confirm hepatobiliary fascioliasis. CT-scan and MRI are important tools in differentiate diagnosis with other hepatobiliary systems’ diseases.