Changes in sonographic findings after treatment of patients with clonorchiasis in a heavy endemic area

Abstract

We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) was observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.

Keywords: Clonorchis sinensis; abdominal sonography; dilatation of intrahepatic bile ducts; floating echogenic foci in the gallbladder; periductal echogenicity; praziquantel.

Fig. 1

Sonograms of a patient with egg-negative conversion by treatment. Transverse scan before treatment (A) of the left hepatic lobe shows severe dilatation of the intrahepatic bile ducts (IHDs) (arrows). Diameter of the IHD is larger than that of the adjacent portal vein. Dilatation of the IHD is improved to mild degree (arrows) 1 year after treatment (B). IHD is dilated but its diameter is smaller than that of the adjacent portal vein.

Fig. 2

Sonograms of another patient with egg-negative conversion. Transverse scan before treatment (A) of the right hepatic lobe shows moderately increased periductal echogenicity (arrows). Increased periductal echogenicity is improved to mild degree (arrows) 1 A B year after treatment (B).

Fig. 3

Sonograms of a patient with egg-negative conversion after treatment. Many floating echogenic foci (arrows) in the gallbladder before treatment (A) are no longer seen 1 A B year after treatment (B).