From the Research
The management of liver calcification found on ultrasound should prioritize identifying the underlying cause, as calcifications themselves are not a disease but a sign of various conditions, and most recent evidence suggests a pattern recognition approach on CT can increase specificity for various diagnoses 1. The initial evaluation should include a comprehensive medical history, physical examination, and additional imaging such as CT scan or MRI to better characterize the lesions.
- Laboratory tests including liver function tests, viral hepatitis markers, and tumor markers may be necessary to rule out underlying conditions.
- Common causes of liver calcifications include granulomatous diseases (tuberculosis, histoplasmosis), previous infections, hemangiomas, and rarely, malignancies.
- Most liver calcifications are benign and require no specific treatment, but if related to an underlying condition like tuberculosis, appropriate antimicrobial therapy would be prescribed.
- For parasitic infections such as hydatid disease, antiparasitic medications like albendazole (400mg twice daily for 1-6 months) may be indicated, as suggested by older studies 2, 3.
- If malignancy is suspected, referral to oncology for potential biopsy and treatment planning is warranted.
- Regular follow-up imaging every 6-12 months is recommended for stable, asymptomatic calcifications to monitor for changes, and patients should be reassured that isolated liver calcifications are often incidental findings with no clinical significance, but proper evaluation is important to rule out serious underlying conditions.
- Recent studies also suggest that susceptibility-weighted imaging (SWI) can be used to identify hepatic calcifications, especially in cases of echinococcosis, with a high sensitivity and specificity 4.
- However, the choice of imaging modality should be based on the clinical context and the availability of resources.