PDF | On Mar 1, 2009, Neil U Lall and others published Caroli disease and the central dot sign | Find, read and cite all the research you need on ...ArticlePDFAvailableCarolidiseaseandthecentraldotsignMarch2009PediatricRadiology39(7):754DOI:10.1007/s00247-009-1147-3SourcePubMedAuthors:NeilUttamLallEmoryHospitalsMarkHoganNationwideChildren'sHospitalDownloadfull-textPDFReadfull-textDownloadfull-textPDFReadfull-textDownloadcitationCopylinkLinkcopiedReadfull-textDownloadcitationCopylinkLinkcopiedCitations(9)References(3)Figures(2)Figures… … Figures-uploadedbyNeilUttamLallAuthorcontentAllfigurecontentinthisareawasuploadedbyNeilUttamLallContentmaybesubjecttocopyright.Discovertheworld'sresearch20+millionmembers135+millionpublications700k+researchprojectsJoinforfreePublicFull-text1ContentuploadedbyNeilUttamLallAuthorcontentAllcontentinthisareawasuploadedbyNeilUttamLallonJul21,2014Contentmaybesubjecttocopyright.CLINICALIMAGECarolidiseaseandthecentraldotsignNeilU.Lall&MarkJ.HoganReceived:18September2008/Revised:4December2008/Accepted:7January2009/Publishedonline:17February2009#Springer-Verlag2009A12-month-oldboypresentedwithfever,Klebsiellabacteremia,emesis,andabdominalpain.USdemonstratedmultipleintrahepaticcystscontainingfibrovascularbundles,knownasthecentraldotsign(Fig.1).Subsequentpercuta-neoustranshepaticcholangiographyshowedsegmentalsaccularbiliaryductaldilation(Fig.2).Carolidiseaseisararecongenitalcysticdilatationoftheintrahepaticbileducts.Thispredisposestobiliarystasisandconsequentlithiasis,cholangitis,abscesses,andsepticemia.Additionally,childrenfaceincreasedriskofhepaticfibrosis(termedCarolisyndrome),renaldisease,cholangiocarcinoma,andamyloidosis[2].ThecentraldotsignonUSandCTisindicativeofCarolidisease,butcanalsobeseeninperibiliarycysts,obstructivejaundice,andperiportallym-phedema[1].Cholangiographyisthemostsensitiveradio-graphicstudy,becausecommunicationbetweenbileductsandcysticloculationsisimportanttodifferentiatefrommultiplelivercysts[2];theroleofmagneticresonance