Multiple comet tail artifacts in the liver: a case of congenital hepatic fibrosis showing unusual biliary appearance

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• 作者：Michiko Kuwano (1)
  Hitoshi Maruyama (2)
  Takayuki Kondo (2)
  Tadashi Sekimoto (2)
  Taro Shimada (2)
  Shuichi Yamamoto (1)
  Toshio Tuyuguchi (2)
  Osamu Yokosuka (2)
  Fumio Nomura (1)
  
• 关键词：Congenital hepatic fibrosis ; Comet tail artifact ; Liver
• 刊名：Journal of Medical Ultrasonics
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：41
• 期：3
• 页码：377-380
• 全文大小：693 KB
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• 作者单位：Michiko Kuwano (1)
  Hitoshi Maruyama (2)
  Takayuki Kondo (2)
  Tadashi Sekimoto (2)
  Taro Shimada (2)
  Shuichi Yamamoto (1)
  Toshio Tuyuguchi (2)
  Osamu Yokosuka (2)
  Fumio Nomura (1)
  
  1. The Clinical Laboratory, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan
  2. Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan
  
• ISSN：1613-2254

文摘

Congenital hepatic fibrosis (CHF) is a form of autosomal recessive polycystic kidney disease. Because of the common underlying pathophysiology of ductal plate malformation, CHF can be accompanied by an abnormal biliary appearance, which is characterized by a saccular or fusiform dilatation of the bile ducts. We encountered the case of a 35-year-old man suffering from CHF concomitant with esophageal varices, which were treated by endoscopic sclerotherapy. The patient had elevated serum concentrations of alkaline phosphatase and γ-glutamyl transpeptidase without apparent biliary disease, including hepatolithiasis or a history of cholangitis. Magnetic resonance cholangiography showed an abnormal biliary appearance, which was not saccular or fusiform but had multiple stenosis with unknown causes. B-mode sonogram showed multiple comet tail artifacts in the liver parenchyma, probably corresponding to the compact fibrosis bands and bile in the bile duct as well as peripheral bile duct dilatation, which was proven pathologically. We propose that multiple comet tail artifacts in the liver may suggest the presence of a bile duct abnormality in patients with CHF, suggesting the potential risk for developing biliary complications.