Hepatic and splenic sarcoidosis: Ultrasound and MR imaging

Abstract

Abdominal imaging studies may be performed for various indications in patients known to have sarcoidosis. To assess magnetic resonance imaging (MRI) and sonographic ability to detect abnormalities in sarcoidosis patients with abdominal involvement, a prospective study on 18 selected patients was performed. Besides organomegaly, when present, ultrasound demonstrated normal or increased hepatic parenchymal echogenicity, coarsening of the liver parenchyma with or without discrete nodules, focal calcifications, as well as contour irregularity. Splenic discrete nodules were seen on ultrasound in a single patient. Besides organomegaly, MRI abnormalities include abnormal hepatic signal intensity, discrete nodules, contour irregularity, speculation of small hepatic vascular branches, and a high periportal signal intensity. MRI splenic abnormalities include contour irregularity, nodularity, and abnormal signal intensity. The data presented in this study reveals the spectrum of ultrasound and MRI findings in sarcoidosis patients with abdominal organ involvement, potentially enabling the evaluation of the severity of the disease. MRI appears more sensitive than ultrasound for study of abdominal sarcoidosis.

Abdominal sarcoidosis: cross-sectional imaging findings

“…5b) (22). Contour irregularity of the liver and high periportal signal intensity are the other reported MRI findings of hepatic sarcoidosis (19).…”

“…They have been reported to be hypoechoic on US and hypodense on CT scans, relative to the liver parenchyma (Fig. 2) (19). However, they may also be hyperechoic depending on background liver echogenicity and the degree of fibrosis present in the granuloma.…”

“…Ultrasonography (US) findings of hepatic sarcoidosis include increased parenchymal echogenicity and coarsening of the parenchymal appearance with or without discrete nodules ( Fig. 1) (19). Calcification can rarely be seen if the disease is long-standing (19).…”

“…1) (19). Calcification can rarely be seen if the disease is long-standing (19). The nodules which represent the coalescence of small granulomas are typically innumerable, diffusely distributed, and range from 1-2 mm to several centimeters in size.…”

Splenic focal lesions as manifestation of sarcoidosis: Characterization with contrast‐enhanced sonography

“…In spite of frequent hepatosplenic involvement, abdominal imaging studies usually show only a nonspecific heterogeneous hepatosplenomegaly. The presence of nodules in the liver and spleen on sonography and CT is unusual 4,6,[8][9][10] and has been reported in only 5% of hepatic sarcoidoses and 15% of splenic sarcoidosis. 10,11 The detection of hepatic or splenic focal lesions, as in our case, triggers a wider differential diagnosis that includes other conditions such as metastatic disease and lymphoma.…”