Journal of Ultrasound in Medicine, Vol 8, Issue 5 247-254, Copyright © 1989 by American Institute of Ultrasound in Medicine
Hepatic and biliary tract abnormalities in patients with AIDS. Sonographic-pathologic correlation
K. Grumbach, B. G. Coleman, A. A. Gal, P. H. Arger, M. C. Mintz, R. L. Arenson and L. Aquino
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
A retrospective evaluation of hepatobiliary sonograms in 22 patients with
AIDS was performed and the sonographic abnormalities were correlated with
pathologic findings in 10 patients. Hepatic parenchymal abnormalities noted
on ultrasound include a hyperechoic parenchymal echo pattern in 45.5%,
hepatomegaly in 41%, and focal masses in 9% of patients. Etiologies for the
diffuse hyperechoic pattern based on pathologic correlation in eight cases
were hepatic steatosis and granulomatous hepatitis. Biliary tract
abnormalities identified included gallbladder wall thickening in 55% of
patients, dilated gallbladder in 18%, biliary sludge in 23%, and gallstones
in 5% of patients. Extrahepatic ductal dilation was seen in 23% of
patients, but the intrahepatic ducts were dilated in only 5% of patients.
Possible etiologies for biliary tract abnormalities suggested by pathologic
correlation in five patients and literature review were cytomegalovirus and
cryptosporidial infection, although constitutional factors may have played
a role. Hepatobiliary ultrasound is, therefore, an effective screening tool
for directing further diagnostic and therapeutic procedures in AIDS
patients presenting with clinical evidence of hepatobiliary dysfunction.
