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Imaging diagnosis of clonorchiasis

Dongil Choi1, Sung-Tae Hong2
The Korean Journal of Parasitology 2007;45(2):77-85.
Published online: June 20, 2007

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Corresponding author (hst@snu.ac.kr)
• Received: March 16, 2007   • Accepted: May 9, 2007

Copyright © 2007 by The Korean Society for Parasitology

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Imaging diagnosis of clonorchiasis
Korean J Parasitol. 2007;45(2):77-85.   Published online June 20, 2007
DOI: https://doi.org/10.3347/kjp.2007.45.2.77
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DOI: https://doi.org/10.3347/kjp.2007.45.2.77
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Imaging diagnosis of clonorchiasis
Image Image Image Image Image Image Image
Fig. 1 Cholangiograms of clonorchiasis showing "too many intrahepatic ducts" signs. A. By percutaneous biliary drainage catheter (arrows) in a 58-year-old man, showing diffuse and uniform dilatation of the peripheral intrahepatic bile ducts. B. Endoscopic retrograde cholangiography in a 70-year-old man, with diffuse dilatation of the peripheral intrahepatic bile ducts, but no dilatation of the extrahepatic bile duct. C. Multiple, oval, small filling defects (arrows) within the dilated peripheral intrahepatic bile ducts, representing the flukes in a 55-year-old man. D. Magnetic resonance (MR) cholangiography in a 70-year-old man with diffuse dilatation of the peripheral intrahepatic bile ducts.
Fig. 2 Liver sonograms of clonorchiasis. A. In a 57-year-old man, transverse scan of the left hepatic lobe, showing mild dilatation of the intrahepatic bile ducts (arrows). B. In a 56-year-old man with the increased periductal echogenicity (arrows) along the dilated intrahepatic bile ducts. C. Oblique scan of the gallbladder of a heavily - infected Chinese man with several floating echogenic foci (arrows), which probably indicate worms or desquamated materials. D. Mild dilatation of the intrahepatic bile ducts in the central liver of a cured 60-year-old man.
Fig. 3 Contrast-enhanced CT findings of the liver in clonorchiasis patients. A. A 52-year-old man, who underwent liver transplantation in China 1 month before CT examination, shows diffuse and mild dilatation of the peripheral intrahepatic bile ducts (arrows). The transplanted liver had been infected with C. sinensis. B. Periductal enhancement (arrows) with the thickened bile duct walls on hepatic arterial phase of dynamic study, which possibly represents active infection, in a 61-year-old man.
Fig. 4 MR findings of the liver in clonorchiasis patients. A. MR cholangiography in a 58-year-old man, who underwent cholecystectomy 10 year ago, showing diffuse and uniform dilatation of the peripheral intrahepatic bile ducts. B. Periductal enhancement of mildly dilated intrahepatic bile ducts (arrows) on hepatic arterial phase of dynamic study of gadolinium-enhanced echo fast gradient echo 3D (TR/TE, 7/2) transverse image, which possibly represents active infection, in a 60-year-old man (Courtesy of Dr. Yong Yeon Jeong, Gwangju, Korea).
Fig. 5 Cholangiocarcinoma in the right hepatic lobe, with clonorchiasis, in a 63-year-old man. There is diffuse dilatation of peripheral intrahepatic bile ducts (arrowheads) is attributed to changes of a C. sinensis infection, and segmental and more severe dilatation around the tumor is caused by obstruction by the tumor (arrows).
Fig. 6 Cholangiocarcinoma in the mid common duct, with clonorchiasis, in a 64-year-old man. A. MR cholangiography shows a diffuse dilatation of the intrahepatic bile ducts and common duct. Note an intraluminal tumor (arrows) at the level of the mid common duct. B. Contrast-enhanced CT shows diffuse and marked dilatation of the intrahepatic bile ducts. C. CT at a level lower than (B) shows the enhancing, segmental thickened wall (arrows) of the mid common duct, which represents an extrahepatic cholangiocarcinoma.
Fig. 7 Cholangiocarcinoma in the mid common duct, without clonorchiasis, in a 65-year-old woman. A. MR cholangiography shows an intraluminal tumor (arrows) at the level of the mid common duct. B. Contrast-enhanced CT shows minimal dilatation of the central intrahepatic duct (arrows), but the peripheral intrahepatic ducts are not dilated. C. CT at a level lower than (B) shows the enhancing, segmental thickened wall (arrows) of the mid common duct, which represents an extrahepatic cholangiocarcinoma.

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Imaging diagnosis of clonorchiasis
PHD : Parasites, Hosts and Diseases

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