Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Imaging diagnosis of clonorchiasis

  • Choi, Don-Gil (Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine) ;
  • Hong, Sung-Tae (Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine)
  • Published : 2007.06.30
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Abstract

Among several diagnostic tools for clonorchiasis (Clonorchis sinensis infection), radiologic examinations are commonly used in clinical practices. During the 2 past decades, many reports regarding imaging findings of clonorchiasis were introduced. The basic imaging finding of clonorchiasis is diffuse dilatation of the peripheral intra-hepatic bile ducts, without dilation of the large intrahepatic or extrahepatic bile ducts. By this finding, however, active clonorchiasis cannot be differentiated from cured infection. Some recent radiologic studies suggested specific findings of active clonorchiasis. Besides direct demonstration of worms, increased periductal echogenicity on sonography and periductal enhancement on dynamic contrast-enhanced CT or MR imaging possibly represent active clonorchiasis. Those images of the liver clonorchiasis are known to be correlated with worm burdens (EPG counts) in their frequency and also severity. The images of cholangiocarcinoma associated with clonorchiasis show both the tumor with obstruction images and diffuse dilatation of the peripheral intrahepatic bile ducts. Radiological images can be a good practical alternative diagnostic method of clonorchiasis.

Keywords

References

  1. Barish MA, Soto JA (1997) MR cholangiopancreatography: technique and clinical applications. AJR Am J Roentgenol 169: 1295-1303 https://doi.org/10.2214/ajr.169.5.9353445
  2. Belamaric J (1973) Intrahepatic bile duct carcinoma and C. sinensis infection in Hong Kong. Cancer 31: 468-473 https://doi.org/10.1002/1097-0142(197302)31:2<468::AID-CNCR2820310226>3.0.CO;2-J
  3. Chen M, Lu Y, Hua X, Mott KE (1994) Progress in assessment of morbidity due to Clonorchis sinensis infection: a review of recent literature. Trop Dis Bull 91: R7-R65
  4. Choi BI, Kim HJ, Do YS, Han MH, Lee SH (1989) CT findings of clonorchiasis. AJR Am J Roentgenol 152: 281-284 https://doi.org/10.2214/ajr.152.2.281
  5. Choi BI, Kim TK, Han JK (1998) MRI of clonorchiasis and cholangiocarcinoma. JMRI 8: 359-366 https://doi.org/10.1002/jmri.1880080215
  6. Choi BI, Park JH, Kim YI, Yu ES, Kim SH, Kim WH, Kim CY, Han MC (1988) Peripheral cholangiocarcinoma and clonorchiasis: CT findings. Radiology 169: 149-153 https://doi.org/10.1148/radiology.169.1.2843940
  7. Choi D, Hong ST, Lim JH, Cho SY, Rim HJ, Ji Z, Yuan R, Wang S (2004) Sonographic findings of active Clonorchis sinensis infection. J Clin Ultrasound 32: 17-23 https://doi.org/10.1002/jcu.10216
  8. Choi D, Lim JH, Hong ST (2004) Relation of cholangiocarcinomas to clonorchiasis and bile duct stones. Abdom Imaging 29: 590-597
  9. Choi D, Lim JH, Lee KT, Lee JK, Choi SH, Heo JS, Jang KT, Lee NY, Kim S, Hong ST (2006) Cholangiocarcinoma and Clonorchis sinensis infection: a case-control study in Korea. J Hepatol 44: 1066-1073 https://doi.org/10.1016/j.jhep.2005.11.040
  10. Choi D, Lim JH, Kim SK, Kim EY, Lee M, Hong ST (1999) Long-lasting sonographic and histopathological findings in cured clonorchiasis of rabbits. Korean J Parasitol 37: 77-83 https://doi.org/10.3347/kjp.1999.37.2.77
  11. Choi MS, Choi D, Choi MH, Ji Z, Li Z, Cho SY, Hong KS, Rim HJ, Hong ST (2005) Correlation between sonographic findings and infection intensity in clonorchiasis. Am J Trop Med Hyg 73: 1139-1144
  12. Choi TK, Wong KP, Wong J (1984) Cholangiographic 84 Korean J. Parasitol. Vol. 45, No. 2: 77-85, June 2007 appearance in clonorchiasis. Br J Radiol 57: 681-684
  13. Hong ST (2003) Clonorchis sinensis. In International handbook of foodborne pathogens, Miliotis MD, Bier JW (eds). pp 581-592, Marcel Dekker Inc, New York, USA
  14. Hong ST, Choi MH, Kim CH, Chung BS, Ji Z (2003) The Kato-Katz method is reliable for diagnosis of Clonorchis sinensis infection. Diagn Microbiol Infect Dis 47: 345-347 https://doi.org/10.1016/S0732-8893(03)00113-5
  15. Hong ST, Park KH, Seo M, Choi BI, Chai JY, Lee SH (1994) Correlation of sonographic findings with histopathological changes of the bile ducts in rabbits infected with Clonorchis sinensis. Korean J Parasitol 32: 223-230 https://doi.org/10.3347/kjp.1994.32.4.223
  16. Hong ST, Yoon K, Lee M, Seo M, Choi MH, Sim JS, Choi BI, Yun CK, Lee SH (1998) Control of clonorchiasis by repeated praziquantel treatment and low diagnostic efficacy of sonography. Korean J Parasitol 36: 249-254 https://doi.org/10.3347/kjp.1998.36.4.249
  17. International Agency for Research on Cancer working group (1994) Infection with liver flukes (Opisthorchis viverrini, Opisthorchis felinneus and Clonorchis sinensis). IARC Monogr Eval Carcinog Risks Hum 61: 121-175
  18. Ito K, Mitchell DB, Outwater EK, Blasbalg R (1999) Primary sclerosing cholangitis: MR imaging features. AJR Am J Roentgenol 172: 1527-1533 https://doi.org/10.2214/ajr.172.6.10350284
  19. Jeong YY, Kang HK, Kim JW, Yoon W, Chung TW, Ko SW (2004) MR imaging findings of clonorchiasis. Korean J Radiol 5: 25-30 https://doi.org/10.3348/kjr.2004.5.1.25
  20. Kim MJ, Cha SW, Mitchell DG, Chung JJ, Park S, Chung JB (1999) MR imaging findings in recurrent pyogenic cholangitis. AJR Am J Roentgenol 173: 1545-1549 https://doi.org/10.2214/ajr.173.6.10584799
  21. Korea Association of Health Promotion (2004) Prevalence of intestinal parasitic infections in Korea - the 7th Report-. Seoul, Korea
  22. Lee JH, Rim HJ, Sell S (1997) Heterogeneity of the 'ovalcell' response in the hamster liver during cholangiocarcinogenesis following Clonorchis sinensis infection and dimethylnitrosamine treatment. J Hepatol 26: 1313-1323 https://doi.org/10.1016/S0168-8278(97)80467-9
  23. Lee KH, Hong ST, Han JK, Yoon CJ, Lee S, Kim SH, Choi BI (2003) Experimental clonorchiasis in dogs: CT findings before and after treatment. Radiology 228: 131-138 https://doi.org/10.1148/radiol.2281012128
  24. Lim JH (1990) Radiologic findings of clonorchiasis. AJR Am J Roentgenol 155: 1001-1008 https://doi.org/10.2214/ajr.155.5.2120925
  25. Lim JH (1991) Oriental cholangiohepatitis: pathologic, clinical, and radiologic features. AJR Am J Roentgenol 157: 1- 8 https://doi.org/10.2214/ajr.157.1.2048504
  26. Lim JH, Ko YT, Lee DH, Kim SY (1989) Clonorchiasis: sonographic findings in 59 proved cases. AJR Am J Roentgenol 152: 761-764 https://doi.org/10.2214/ajr.152.4.761
  27. Lim JH, Ko YT, Lee DH, Lee KS, Suh SJ, Woo SK (1992) Clonorchiasis and its complications: cholangiogram revisited. J Korean Radiol Soc 28: 229-235 https://doi.org/10.3348/jkrs.1992.28.2.229
  28. Lim MK, Ju YH, Franceschi S, Oh JK, Kong HJ, Hwang SS, Park SK, Cho SI, Sohn WM, Kim DI, Yoo KY, Hong ST, Shin HR (2006) Clonorchis sinensis infection and increasing risk of cholangiocarcinoma in the Republic of Korea. Am J Trop Med Hyg 75: 93-96
  29. Shin HR, Lee CU, Park HY, Seol SY, Chung JM, Choi HC, Ahn YO, Shigemastu T (1996) Hepatitis B and C virus, Clonorchis sinensis for the risk of liver cancer: a case-control study in Pusan, Korea. Int J Epidemiol 25: 933-940 https://doi.org/10.1093/ije/25.5.933