Pyogenic liver abscess CT: Difference between revisions
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==Overview== | ==Overview== | ||
[[CT scan]] findings of pyogenic liver abscess include peripherally enhancing and centrally hypo attenuating lesions, solid or gas in the lesions (gas in the form of bubbles or air fluid levels), segmental, wedge-shaped or circumferential [[perfusion]] abnormalities, early enhancement may be seen on contrast enhanced CT scans, the double target sign and cluster sign (shown below).<ref name="pmid27232504">{{cite journal| author=Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E et al.| title=Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. | journal=Radiographics | year= 2016 | volume= 36 | issue= 4 | pages= 1001-23 | pmid=27232504 | doi=10.1148/rg.2016150196 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27232504 }} </ref><ref name="pmid8161903">{{cite journal| author=Lee TY, Wan YL, Tsai CC| title=Gas-containing liver abscess: radiological findings and clinical significance. | journal=Abdom Imaging | year= 1994 | volume= 19 | issue= 1 | pages= 47-52 | pmid=8161903 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8161903 }} </ref><ref name="pmid3969480">{{cite journal| author=Mathieu D, Vasile N, Fagniez PL, Segui S, Grably D, Lardé D| title=Dynamic CT features of hepatic abscesses. | journal=Radiology | year= 1985 | volume= 154 | issue= 3 | pages= 749-52 | pmid=3969480 | doi=10.1148/radiology.154.3.3969480 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3969480 }} </ref><ref name="pmid3261506">{{cite journal| author=Jeffrey RB, Tolentino CS, Chang FC, Federle MP| title=CT of small pyogenic hepatic abscesses: the cluster sign. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 3 | pages= 487-9 | pmid=3261506 | doi=10.2214/ajr.151.3.487 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3261506 }} </ref> | |||
==CT Scan== | |||
==CT== | [[CT scan]] findings of pyogenic liver abscess include:<ref name="pmid27232504">{{cite journal| author=Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E et al.| title=Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. | journal=Radiographics | year= 2016 | volume= 36 | issue= 4 | pages= 1001-23 | pmid=27232504 | doi=10.1148/rg.2016150196 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27232504 }} </ref><ref name="pmid8161903">{{cite journal| author=Lee TY, Wan YL, Tsai CC| title=Gas-containing liver abscess: radiological findings and clinical significance. | journal=Abdom Imaging | year= 1994 | volume= 19 | issue= 1 | pages= 47-52 | pmid=8161903 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8161903 }} </ref><ref name="pmid3969480">{{cite journal| author=Mathieu D, Vasile N, Fagniez PL, Segui S, Grably D, Lardé D| title=Dynamic CT features of hepatic abscesses. | journal=Radiology | year= 1985 | volume= 154 | issue= 3 | pages= 749-52 | pmid=3969480 | doi=10.1148/radiology.154.3.3969480 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3969480 }} </ref><ref name="pmid3261506">{{cite journal| author=Jeffrey RB, Tolentino CS, Chang FC, Federle MP| title=CT of small pyogenic hepatic abscesses: the cluster sign. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 3 | pages= 487-9 | pmid=3261506 | doi=10.2214/ajr.151.3.487 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3261506 }} </ref> | ||
CT scan findings of pyogenic liver abscess include:<ref name="pmid27232504">{{cite journal| author=Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E et al.| title=Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls. | journal=Radiographics | year= 2016 | volume= 36 | issue= 4 | pages= 1001-23 | pmid=27232504 | doi=10.1148/rg.2016150196 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27232504 }} </ref><ref name="pmid8161903">{{cite journal| author=Lee TY, Wan YL, Tsai CC| title=Gas-containing liver abscess: radiological findings and clinical significance. | journal=Abdom Imaging | year= 1994 | volume= 19 | issue= 1 | pages= 47-52 | pmid=8161903 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8161903 }} </ref><ref name="pmid3969480">{{cite journal| author=Mathieu D, Vasile N, Fagniez PL, Segui S, Grably D, Lardé D| title=Dynamic CT features of hepatic abscesses. | journal=Radiology | year= 1985 | volume= 154 | issue= 3 | pages= 749-52 | pmid=3969480 | doi=10.1148/radiology.154.3.3969480 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3969480 }} </ref><ref name="pmid3261506">{{cite journal| author=Jeffrey RB, Tolentino CS, Chang FC, Federle MP| title=CT of small pyogenic hepatic abscesses: the cluster sign. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 3 | pages= 487-9 | pmid=3261506 | doi=10.2214/ajr.151.3.487 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3261506 }} </ref> | *Peripherally enhancing and centrally hypo attenuating lesions | ||
*Peripherally enhancing and centrally | |||
*Solid or gas in the lesions (gas in the form of bubbles or air fluid levels) | *Solid or gas in the lesions (gas in the form of bubbles or air fluid levels) | ||
*Segmental, wedge-shaped or circumferential perfusion abnormalities, with early enhancement, may be seen | *Segmental, wedge-shaped or circumferential [[perfusion]] abnormalities, with early enhancement, may be seen | ||
*On contrast enhanced CT scans, the double target sign is a characteristic imaging feature of liver abscess | *On contrast enhanced [[CT]] scans, the double target sign is a characteristic imaging feature of [[liver abscess]] | ||
*Double target sign | *Double target sign: | ||
:*Central low attenuation lesion (fluid filled) is surrounded by a high attenuation inner rim and a low attenuation outer ring | :*Central low attenuation lesion (fluid filled) is surrounded by a high attenuation inner rim and a low attenuation outer ring | ||
:*The inner ring (abscess membrane) indicates early contrast enhancement which persists on delayed images, in contrast to the outer rim ( | :*The inner ring ([[abscess]] membrane) indicates early contrast enhancement which persists on delayed images, in contrast to the outer rim ([[edema]] of the [[liver]] [[parenchyma]]) which only enhances on delayed phase | ||
*Cluster sign | *Cluster sign (shown below): | ||
:*Feature of pyogenic liver abscess | :*Feature of pyogenic liver abscess | ||
:*Aggregation of multiple low attenuation liver lesions in a | :*Aggregation of multiple low attenuation liver lesions in a localized area to form a solitary larger [[abscess]] cavity | ||
[[File:Hepatic-abscess-large-left-lobe3.jpg|Pyogenic liver abscess|500px]] | |||
[[Image:pyogenic-liver-abscess-4.jpg|500px|Case courtesy of Dr Laughlin Dawes , <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/35962">rID: 35962</a>]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
Latest revision as of 23:54, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
CT scan findings of pyogenic liver abscess include peripherally enhancing and centrally hypo attenuating lesions, solid or gas in the lesions (gas in the form of bubbles or air fluid levels), segmental, wedge-shaped or circumferential perfusion abnormalities, early enhancement may be seen on contrast enhanced CT scans, the double target sign and cluster sign (shown below).[1][2][3][4]
CT Scan
CT scan findings of pyogenic liver abscess include:[1][2][3][4]
- Peripherally enhancing and centrally hypo attenuating lesions
- Solid or gas in the lesions (gas in the form of bubbles or air fluid levels)
- Segmental, wedge-shaped or circumferential perfusion abnormalities, with early enhancement, may be seen
- On contrast enhanced CT scans, the double target sign is a characteristic imaging feature of liver abscess
- Double target sign:
- Central low attenuation lesion (fluid filled) is surrounded by a high attenuation inner rim and a low attenuation outer ring
- The inner ring (abscess membrane) indicates early contrast enhancement which persists on delayed images, in contrast to the outer rim (edema of the liver parenchyma) which only enhances on delayed phase
- Cluster sign (shown below):
- Feature of pyogenic liver abscess
- Aggregation of multiple low attenuation liver lesions in a localized area to form a solitary larger abscess cavity
References
- ↑ 1.0 1.1 Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E; et al. (2016). "Multimodality Imaging of Liver Infections: Differential Diagnosis and Potential Pitfalls". Radiographics. 36 (4): 1001–23. doi:10.1148/rg.2016150196. PMID 27232504.
- ↑ 2.0 2.1 Lee TY, Wan YL, Tsai CC (1994). "Gas-containing liver abscess: radiological findings and clinical significance". Abdom Imaging. 19 (1): 47–52. PMID 8161903.
- ↑ 3.0 3.1 Mathieu D, Vasile N, Fagniez PL, Segui S, Grably D, Lardé D (1985). "Dynamic CT features of hepatic abscesses". Radiology. 154 (3): 749–52. doi:10.1148/radiology.154.3.3969480. PMID 3969480.
- ↑ 4.0 4.1 Jeffrey RB, Tolentino CS, Chang FC, Federle MP (1988). "CT of small pyogenic hepatic abscesses: the cluster sign". AJR Am J Roentgenol. 151 (3): 487–9. doi:10.2214/ajr.151.3.487. PMID 3261506.