Pyogenic liver abscess CT

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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]

CT

CT scan findings of pyogenic liver abscess include:

• Peripherally enhancing and centrally hypoattenuating 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 (oedema of the liver parenchyma) which only enhances on delayed phase

• Cluster sign

• Feature of pyogenic liver abscess
• Aggregation of multiple low attenuation liver lesions in a localised area to form a solitary larger abscess cavity