Pyogenic liver abscess ultrasound: Difference between revisions
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==Overview== | ==Overview== | ||
The ultrasound findings include round or oval shape, hypoechoic appearance with fine and homogeneous echoes, gas bubbles within the [[abscess]], and absence of central [[perfusion]] on color doppler.<ref name="pmid3303877">{{cite journal| author=Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J| title=Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 3 | pages= 499-501 | pmid=3303877 | doi=10.2214/ajr.149.3.499 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3303877 }} </ref><ref name=Abscess>https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017</ref><ref name="pmid17325065">{{cite journal| author=Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC et al.| title=Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. | journal=Radiology | year= 2007 | volume= 242 | issue= 3 | pages= 769-76 | pmid=17325065 | doi=10.1148/radiol.2423051344 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17325065 }} </ref> | The [[ultrasound]] findings include round or oval shape, hypoechoic appearance with fine and homogeneous echoes, gas bubbles within the [[abscess]], and absence of central [[perfusion]] on [[Doppler|color doppler]].<ref name="pmid3303877">{{cite journal| author=Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J| title=Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 3 | pages= 499-501 | pmid=3303877 | doi=10.2214/ajr.149.3.499 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3303877 }} </ref><ref name=Abscess>https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017</ref><ref name="pmid17325065">{{cite journal| author=Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC et al.| title=Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. | journal=Radiology | year= 2007 | volume= 242 | issue= 3 | pages= 769-76 | pmid=17325065 | doi=10.1148/radiol.2423051344 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17325065 }} </ref> | ||
==Ultrasound== | ==[[Ultrasound]]== | ||
The ultrasound findings include:<ref name="pmid3303877">{{cite journal| author=Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J| title=Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 3 | pages= 499-501 | pmid=3303877 | doi=10.2214/ajr.149.3.499 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3303877 }} </ref><ref name=Abscess>https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017</ref><ref name="pmid17325065">{{cite journal| author=Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC et al.| title=Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. | journal=Radiology | year= 2007 | volume= 242 | issue= 3 | pages= 769-76 | pmid=17325065 | doi=10.1148/radiol.2423051344 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17325065 }} </ref> | The [[ultrasound]] findings include:<ref name="pmid3303877">{{cite journal| author=Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J| title=Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 3 | pages= 499-501 | pmid=3303877 | doi=10.2214/ajr.149.3.499 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3303877 }} </ref><ref name=Abscess>https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017</ref><ref name="pmid17325065">{{cite journal| author=Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC et al.| title=Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. | journal=Radiology | year= 2007 | volume= 242 | issue= 3 | pages= 769-76 | pmid=17325065 | doi=10.1148/radiol.2423051344 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17325065 }} </ref> | ||
*Round or oval shape | *Round or oval shape | ||
*Hypoechoic appearance with fine and homogeneous echoes | *Hypoechoic appearance with fine and homogeneous echoes | ||
*Gas bubbles may be seen | *Gas bubbles may be seen | ||
*Absence of central [[perfusion]] on color doppler | *Absence of central [[perfusion]] on [[Doppler|color doppler]] | ||
===Contrast Enhanced Ultrasound=== | ===[[Ultrasound|Contrast Enhanced Ultrasound]]=== | ||
*Enhancement during arterial phase and progressive washout during portal or late phases | *Enhancement during arterial phase and progressive washout during portal or late phases | ||
*The [[liquefactive necrosis|liquefied necrotic]] area does not enhance | *The [[liquefactive necrosis|liquefied necrotic]] area does not enhance. | ||
'''Advantages''' | '''Advantages''' | ||
*The lesion may appear solid and mimic a hepatic tumor, in patients with monomicrobial [[Klebsiella pneumoniae|K. pneumoniae]] abscesses. | *The lesion may appear solid and mimic a [[hepatic tumor]], in patients with monomicrobial [[Klebsiella pneumoniae|K. pneumoniae]] abscesses. | ||
*The use of contrast allows | *The use of contrast allows us to measure the size of the [[necrosis|necrotic area]], characterize the lesion, and to depict internal septations for management purposes. | ||
*In highly septated abscesses and in small [[abscess|abscesses]] (under 3 cm) drainage is not recommended. | *In highly septated abscesses and in small [[abscess|abscesses]] (under 3 cm) drainage is not recommended. | ||
Revision as of 19:11, 31 March 2017
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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
The ultrasound findings include round or oval shape, hypoechoic appearance with fine and homogeneous echoes, gas bubbles within the abscess, and absence of central perfusion on color doppler.[1][2][3]
Ultrasound
The ultrasound findings include:[1][2][3]
- Round or oval shape
- Hypoechoic appearance with fine and homogeneous echoes
- Gas bubbles may be seen
- Absence of central perfusion on color doppler
Contrast Enhanced Ultrasound
- Enhancement during arterial phase and progressive washout during portal or late phases
- The liquefied necrotic area does not enhance.
Advantages
- The lesion may appear solid and mimic a hepatic tumor, in patients with monomicrobial K. pneumoniae abscesses.
- The use of contrast allows us to measure the size of the necrotic area, characterize the lesion, and to depict internal septations for management purposes.
- In highly septated abscesses and in small abscesses (under 3 cm) drainage is not recommended.
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References
- ↑ 1.0 1.1 Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J (1987). "Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison". AJR Am J Roentgenol. 149 (3): 499–501. doi:10.2214/ajr.149.3.499. PMID 3303877.
- ↑ 2.0 2.1 https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017
- ↑ 3.0 3.1 Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC; et al. (2007). "Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings". Radiology. 242 (3): 769–76. doi:10.1148/radiol.2423051344. PMID 17325065.