The Value of Ultrasonography for Screening and Follow-up of Clonorchiasis.

Kim,  Young Min; Rho,  Myung Ho; Chang,  Jeong A; Choi,  Pil Yeop; Jung,  Keon Sik; Seong,  Young Soon; Kwon,  Jae Soo; Lee,  Sang Wook

Journal of Korean Society of Medical Ultrasound 1998;17(4): 333-338.

Young Min Kim, Myung Ho Rho, Jeong A Chang, Pil Yeop Choi, Keon Sik Jung, Young Soon Seong, Jae Soo Kwon, Sang Wook Lee

Department of Diagnostic Radiology, Masan Samsung Hospital, College of medicine, Sungkwynkwan University, Korea.

Published online: January 1, 2001.

ABSTRACT

PURPOSE: To evaluate the value of ultrasonography(US) for screening and follow-up of clonorchiasis. MATERIALS & METHODS: Our study included 24,454 patients who visited our health screening center. One hundred and ninety two patients were suspected of having clonorchiasis on US, and 185 patients were positive for eggs of Clonorchis sinensis on stool samples. US findings such as peripheral intrahepatic bile duct(IHD) dilatation, periductal hyperechogenicity, and floating echogenic foci within GB were analyzed and compared with results of stool exam. Follow-up study was performed in 32 patients. RESULTS: Both US and stool exams were positive in 77 patients, and sensitivity and positive predictive value of ultrasound for clonorchiasis were 41.6(77/185), 40.1%(77/192), respectively. The stool exam was positive in 31 patients among 135 patients who had peripheral IHD dilatation or periductal hyperechogenicity (31/135, 23%). Floating echogenic foci within GB was noted in 17 patients, among which stool exam was positive in 14 patients (14/17, 82.4%). In the remaining 40 patients which had findings of peripheral IHD dilatation or periductal hyperechogenicity and floating echogenic foci within GB, the stool exam was positive in 32 patients(32/40, 80%). In 32 patients who had undergone follow-up US, peripheral IHD dilatation or periductal hyperechogenicity(n=26) persisted for follow-up periods. However, floating echogenic foci within GB(n=15) disappeared after medical treatment . CONCLUSION: US finding of floating echogenic foci with central echolucency within GB has diagnostic value in spite of low sensitivity of US. Although floating echogenic foci within GB disappeared after medical treatment, peripheral IHD dilatation or periductal hyperechogenicity persisted for several years after mediacal treatment. Careful history taking and accurate stool exam are required in the patients with positive US findings.

Keywords: Liver, infection; Parasites; Liver, US