PubMed · 4786595
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G Mougeot. 1973. [Fascioliasis].. https://pubmed.ncbi.nlm.nih.gov/4786595/
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A case of hepatic fascioliasis with an unusual appearance on MRI due to liver iron overload is presented. The diagnosis of fascioliasis was based on positive serological tests and the presence of eggs in the bile. Hepatic lesions of fascioliasis exhibited hyperintense signals on T1 weighted images as well as proton density and T2 weighted images. Histological study of biopsy specimens from the lesions showed central necrosis and peripheral fibrosis with inflammatory cells including eosinophils. Abundant iron deposition in hepatocytes and Kupffer cells was found in specimens from the surrounding liver. These findings suggested that this appearance on MR images was probably due to a decrease in signal intensity in surrounding liver.
Fasciola hepatica is a trematode of herbivorous mammals, and man is infected by accidental ingestion of contaminated raw aquatic vegetables or water. There have been many reports on computed tomographic and cholangiographic features of human fascioliasis. However, findings of magnetic resonance (MR) imaging have not been reported. Hepatic fascioliasis produces three types of lesions in MR images arranged in tract-like fashion. The outermost area presents as an iso-signal area in T1WI, with slightly higher signal intensity in T2WI and diffuse enhancement after i.v. contrast. The second type presents as a well defined low signal area in T1WI, not enhanced, and also shows low signal intensity in T2WI. The third type has low signal intensity in T1WI, is not enhanced, and has high signal intensity in T2WI which is similar to fluid-containing inflammatory lesions such as pyogenic abscess. These findings suggest various changes associated with traumatic hepatitis caused by the migration of the worm in the liver. This diverse signal intensity can be a suggestive finding of fascioliasis.