CT characterization of hepatic tuberculosis

Abstract

Purpose: The purpose of this study was to evaluate the CT features of hepatic tuberculosis (TB). Methods: CT features of 15 cases of clinically and pathologically proved hepatic tuberculosis identified over a five-year period (2010â2015) were retrospectively analyzed. The CT features were analyzed for nature, range and extent of the various pathological patterns. The CT images of chest were also evaluated for any lung abnormality. Results: There were 4 types of hepatic TB: 1. Serohepatic type (n = 2), which showed coalesced multiple nodular hypodense lesions in the subcapsule of the liver with nodular and fusiform uneven calcifications. 2. Parenchymal type (n = 9): included miliary subtype (n = 2), showing diffuse low-density miliary nodules in the liver with no enhancement after contrast administration; cystic subtype (n = 2), demonstrating cystic low-density lesions with no enhancement; nodular subtype (n = 5), showing hypodense lesion with curved edge irregular calcification in three cases, and ill-defined low density lesion with minimal enhancement in two cases. 3. Mixed type (n = 3), which showed the CT features of both parenchymal and serohepatic types. 4. Tuberculous cholangitis (n = 1), dilatation of biliary ducts and calcification along the wall of bile ducts were revealed. Abnormal chest CT scan was found in 9 cases (60%, 9/15). Conclusions: Different types of hepatic TB have various imaging features that closely relates with pathological changes. Recognition and understanding the spectrum of CT features of hepatic TB is helpful for the diagnosis; however, definitive diagnosis still depends on pathological examination. Chest CT scan is also helpful to aid in the diagnosis. Keywords: Hepatic, Tuberculosis, CT, Chest, Pathology