Caroli disease: review of eight cases with emphasis on magnetic resonance imaging features

Background Caroli disease is a rare congenital disorder characterized by segmental, nonobstructive dilatation of intrahepatic bile ducts. The term Caroli syndrome is used for the association of Caroli disease with congenital hepatic fibrosis. Study aims To provide an overview of the clinical presentation and imaging features of Caroli disease and syndrome, with an emphasis on magnetic resonance imaging. Patients and methods Retrospective analysis of medical records on eight patients in whom a histologic diagnosis of Caroli disease or syndrome had been made. Results Presenting signs and symptoms were (hepato)splenomegaly, hematemesis and/or melena, cholangitis, jaundice, and recurrent fever. The central dot sign, defined in the literature as a dot or bundle of strong contrast enhancement within dilated intrahepatic ducts, was found in seven cases on various imaging modalities. A ‘dot-like structure’ was found in one case in which only unenhanced studies were available. There was a tendency toward a right hepatic-lobe predominance. Conclusion There is an overlap between the imaging features of Caroli disease and Caroli syndrome. Our findings support earlier reports that the central dot sign is highly specific for the disease, and that it can be reliably detected by current imaging techniques.