CT characteristics of the sero-hepatic type of hepatic tuberculosis

Abstract

Objective To study the CT features of the sero-hepatic type of hepatic tuberculosis. Methods This is a retrospective, multi-center and cross-sectional study. 17 patients with the sero-hepatic type of hepatic tuberculosis from the Yueqing People’s Hospital (n=5), Second Affiliated Hospital of Wenzhou Medical College (n=5), and Wenzhou People’s Hospital (n=7) were studied. All these patients were fasted for 8 h prior to CT scanning. They underwent enhanced after conventional CT breathless scanning with no abdominal pressure. Results The CT scans displayed 41 lesions in these 17 patients with the sero-hepatic type of hepatic tuberculosis, including a solitary lesion in 13 patients and multiple lesions in 4 patients. The diameter of the lesions varied from 0.8 to 4.7 cm, with a mean ± S. D. of 2.38±4.82 cm. The CT features showed a localized spindle-shaped focal lesion just underneath the liver capsule with resultant concave compression of the adjacent liver tissue (n=22), spotted calcifications in the center of the focal nodules (n=1); and aggregation of multiple low density nodular foci (n=19). Additional CT features included focal nodules surrounded by a small amount of liquid (n=15), compression of adjacent liver tissue (n=22), a small amount of ascites (n=8), and retroperitoneal lymph nodes enlargement (n=2). These nodules showed moderate (n=5) and slight enhancement in the arterial phase (n=36); moderate (n=32) and mild enhancement in the portal venous phase (n=9); and moderate (n=32) and mild enhancement in the parenchymal phase (n=9), respectively. The nodules showed ring-shaped (n=26), honeycomb or multiple ring-shaped enhancement (n=15). The enhanced ring-shaped wall thickness varied from 0.2 to 0.9 cm, with a thin wall (n=30) and a thick wall (n=11). The center of the focal nodule was a low density sac-shaped area, with no obvious contrast enhancement. The CT value was 21 to 39 hu. The infiltrative liver tissues which surrounded the focal nodules were shown as lamellar areas of obvious arterial enhancement, with equidensity in the portal vein phase and equilibrium phase. Conclusions CT showed characteristic features of the sero-hepatic type of hepatic tuberculosis. Clinical and laboratory findings could provide important supplementary information to make the diagnosis. Key words: Hepatic tuberculosis, sero-hepatic type; Tomography, X-ray computed