Diagnostic imaging of hepatic tuberculosis: case series
| Autor: | Nicoletta Fusco, F Di Stefano, Gilda Cuzzi, Vincenzo Schininà, S M Arend, Massimo Cristofaro, Delia Goletti, Fabrizio Albarello, E. Busi Rizzi |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis diagnostic imaging tuberculoma HIV Infections liver 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Pathognomonic Tuberculosis Hepatic Medical imaging Humans Medicine Hepatic tuberculosis Retrospective Studies Ultrasonography medicine.diagnostic_test Coinfection business.industry ultrasound Ultrasound Magnetic resonance imaging Retrospective cohort study Middle Aged medicine.disease Magnetic Resonance Imaging miliary HIV-TB Infectious Diseases Female 030211 gastroenterology & hepatology Tomography Radiology Tomography X-Ray Computed business Interferon-gamma Release Tests CT MRI |
| Zdroj: | International Journal of Tuberculosis and Lung Disease, 22(7), 779 |
| Popis: | BACKGROUND Hepatic tuberculosis (TB) shows non-specific symptoms, and liver imaging may provide diagnostic clues. Here we describe a series of patients with hepatic TB showing characteristic radiological findings. METHODS Single-centre retrospective evaluation of patients with hepatic TB diagnosed over a period of 16 years who underwent ultrasound, computed tomography (CT) and/or magnetic resonance imaging (MRI). Hepatic lesions were classified as miliary, nodular, serohepatic or cholangitis. RESULTS Of 14 patients with hepatic TB, five were co-infected with the human immunodeficiency virus. All patients had additional extrahepatic TB localisations. An interferon-gamma release assay was performed in 11/14 patients, ultrasound and CT were available for all patients and MRI for four. Observed patterns were miliary (n = 6) with multiple nodules < 2 cm; nodular (n = 5), characterised by a variable number of nodules (2-7 cm); and serohepatic (n = 3), with multiple nodular subcapsular lesions with a thin, smooth wall. Shared findings were hypoechoic lesions on ultrasound, hypodense lesions with ring enhancement on CT, while MRI lesions were hypointense on T1- and hyperintense on T2-weighted images. CONCLUSIONS Ultrasound, CT and MRI can independently contribute to detection of hepatic TB. While a miliary pattern or calcifications are characteristic, no pattern is completely pathognomonic and the diagnosis depends on microbiological evidence. Particularly in risk groups, characteristic radiological findings may prompt targeted diagnostic work-up. |
| Databáze: | OpenAIRE |
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