Diagnosis of liver trichinellosis using magnetic resonance imaging (clinical case report)

Anastasiia-Violetta Matsiievska; Volodymyr Bogomaz

doi:10.32345/USMYJ.4(134).2022.15-21

Anastasiia-Violetta Matsiievska Student Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0002-9522-4941
Volodymyr Bogomaz Department of Internal medicine, Faculty of dentistry Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0003-1493-6558

DOI: https://doi.org/10.32345/USMYJ.4(134).2022.15-21

Keywords: trichinellosis, liver, magnetic resonance imaging, ultrasound imaging, human trichi- nellosis.

Abstract

the prevalence of helminthiasis in the world remains quite high and most of them involve the hepatobiliary system. Considering the specificity of treatment plans, timely nosological diagnosis of liver lesions is extremely important. The amount of research on this topic is currently very limited. The aim of the work was an identifying of MRI capability in the diagnosis of liver trichinellosis to ensure timely recognition and differential diagnostic of the disease. Nonspecific focal changes in the liver parenchyma were found in a 30-year-old woman without any oncological history during ultrasound examination. It is known about her trips to Asian countries several years ago. Clinical manifestations that are specific to trichinellosis were not found in the patient. Examination of the patient's abdominal organs on magnetic resonance imaging with 3.0 T field induction (T1-WI, T2-WI, DWI-sequences, bolus dynamic contrast enhancement) showed the presence of a sign of a "curved tunnel" in the liver parenchyma. Serological tests that confirmed the diagnosis of trichinellosis were performed in Great Britain. The patient has no other clinical and laboratory signs of pathology and she still be under clinical observation. According to the data of the literature and our observation, the sign of the "curved tunnel" on magnetic resonance imaging is a sensitive criterion for the diagnosis of trichinellosis of the liver. In the case of clinical and diagnostic uncertainty of local changes in the liver parenchyma after basic radiological studies (sonography, computer tomography) and in the presence of risk factors for helminthiasis, despite the high cost, it is advisable to include MRI of the liver in the patient examination algorithm to speed up the duration and ensure the accuracy of the diagnosis.

References

Bruschi, F., Brunetti, E., & Pozio, E. (2013). Neurotrichinellosis. Handbook of clinical neurology, 114, 243–249. https://doi.org/10.1016/B978-0-444-53490-3.00019-4

Dupuy-Camet J, Bruschi F. (2007) Management and diagnosis of human trichinellosis. In: Dupouy-Camet J, Murrell KD, editors. FAO/WHO/OIE guidelines for the surveillance, management, prevention and control of trichinellosis. Paris, 1st ed. FAO/WHO/OIE :49–80.

Gentilini, M. V., Nuñez, G. G., Roux, M. E., & Venturiello, S. M. (2011). Trichinella spiralis infection rapidly induces lung inflammatory response: the lung as the site of helminthocytotoxic activity. Immunobiology, 216(9), 1054–1063. https://doi.org/10.1016/j.imbio.2011.02.002

Kuntz E, Kuntz H-D (2006) Clinical aspects of liver diseases. 25 parasitic infections and the liver. In: Kuntz E, Kuntz H-D, eds Hepatology. Principles and Practice. 2nd ed. Heidelberg: Springer Medizin Verlag.

Mawhorter, S. D., & Kazura, J. W. (1993). Trichinosis of the central nervous system. Seminars in neurology, 13(2), 148–152. https://doi.org/10.1055/s-2008-1041119

Neghina, R., & Neghina, A. M. (2011). Reviews on trichinellosis (IV): hepatic involvement. Foodborne pathogens and disease, 8(9), 943–948. https://doi.org/10.1089/fpd.2011.0861

Neghina, R., Neghina, A. M., & Marincu, I. (2011). Reviews on trichinellosis (III): cardiovascular involvement. Foodborne pathogens and disease, 8(8), 853–860. https://doi.org/10.1089/fpd.2010.0815

Neghina, R., Neghina, A. M., Marincu, I., & Iacobiciu, I. (2011). Reviews on trichinellosis (I): renal involvement. Foodborne pathogens and disease, 8(2), 179–188. https://doi.org/10.1089/fpd.2010.0704

Pozio E. (2007). World distribution of Trichinella spp. infections in animals and humans. Veterinary parasitology, 149(1-2), 3–21. https://doi.org/10.1016/j.vetpar.2007.07.002

Wang C. H. (1997). Study of biological properties of trichinella spiralis newborn larvae and the antiparasitic mucosal immunity of the host. Frontiers in bioscience : a journal and virtual library, 2, d317–d330. https://doi.org/10.2741/a194

Wang, C. H., & Bell, R. G. (1986). Trichinella spiralis: newborn larval migration route in rats reexamined. Experimental parasitology, 61(1), 76–85. https://doi.org/10.1016/0014-4894(86)90137-2

Xiong, Z., Shen, Y., Li, Z., Hu, X., & Hu, D. (2021). 'Curved tunnel' sign on MRI: a typical radiological feature in hepatic trichinellosis. Abdominal radiology (New York), 46(6), 2584–2594. https://doi.org/10.1007/s00261-021-02952-w

Богомаз В.М., Карвась Н.В. (2019) Клінічні переваги застосування високопольної магнітно-резонансної томографії з напругою поля 3 Т.// Практикуючий лікар. – Том 8, № 2. – С. 50-53.

Пішак В.П., Бойчук Т.М., Бажора Ю.І. (2003) Клінічна паразитологія - С. 245-252.