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Dynamic CT of Hepatic Abscesses

Significance of Transient Segmental Enhancement

¹ All authors: Department of Radiology, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa City, Ishikawa, 920-8641 Japan.

View larger version (159K): [in a new window]   Fig. 1A. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Unenhanced CT scan shows hypodense mass (arrow) with poorly defined margin at periphery of right posterior segment of liver.

View larger version (176K): [in a new window]   Fig. 1B. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Early phase (30 sec) dynamic contrast-enhanced CT scan shows double-target sign consisting of central cystic area with inner enhanced rim and outer hypodense zone. Note wedge-shaped enhancement (arrowheads) of hepatic parenchyma surrounding mass.

View larger version (166K): [in a new window]   Fig. 1C. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Late phase (90 sec) dynamic CT scan shows thick rim enhancement (arrow). Wedge-shaped enhancement is no longer seen.

View larger version (155K): [in a new window]   Fig. 1D. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Photomicrograph shows organized abscess (AB) and prominent portal tracts caused by inflammation surrounding abscess. (H and E, x2.5)

View larger version (218K): [in a new window]   Fig. 1E. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Photomicrograph shows organized abscess composed of inflammatory cell infiltration and fibrosis. (H and E, x50)

View larger version (173K): [in a new window]   Fig. 1F. —Multiple pathologically proven hepatic abscesses in 64-year-old man. Photomicrograph shows portal tracts surrounding abscess with marked periportal inflammatory cell infiltration and stenosis of portal venule (PV). HA = hepatic arteriole, BD = intrahepatic bile ductule. (H and E, x50)

View larger version (181K): [in a new window]   Fig. 2A. —Hepatic abscesses in 64-year-old man undergoing antibiotic therapy. Early phase dynamic CT scan shows double-target sign (arrow) and segmental enhancement (arrowhead).

View larger version (175K): [in a new window]   Fig. 2B. —Hepatic abscesses in 64-year-old man undergoing antibiotic therapy. Late phase dynamic CT scan shows central hypodense abscess cavity with peripheral enhancement (arrow).

View larger version (152K): [in a new window]   Fig. 2C. —Hepatic abscesses in 64-year-old man undergoing antibiotic therapy. Follow-up early phase dynamic CT scan 10 days after antibiotic therapy shows decrease in segmental enhancement (arrowhead) and size of abscess cavity.

View larger version (173K): [in a new window]   Fig. 3A. —Hepatic abscess in 65-year-old man treated with abscess drainage and antibiotic therapy. Early phase dynamic CT scan shows hypodense mass with double-target sign (arrow) and large segmental enhancement (arrowheads).

View larger version (157K): [in a new window]   Fig. 3B. —Hepatic abscess in 65-year-old man treated with abscess drainage and antibiotic therapy. Follow-up early phase dynamic CT scan 16 days after abscess drainage and antibiotic therapy shows decrease in size of abscess (arrow) and segmental enhancement (arrowhead).

View larger version (166K): [in a new window]   Fig. 4A. —Pathologically proven hepatic abscess in 59-year-old man. Early phase dynamic CT scan shows segmental enhancement (arrowheads) surrounding abscess (arrow) of left lateral segment.

View larger version (173K): [in a new window]   Fig. 4B. —Pathologically proven hepatic abscess in 59-year-old man. Late phase dynamic CT scan shows rim enhancement (arrow).

View larger version (163K): [in a new window]   Fig. 4C. —Pathologically proven hepatic abscess in 59-year-old man. CT during arterial portography image shows segmental portal perfusion defect (arrowheads) surrounding abscess.

View larger version (169K): [in a new window]   Fig. 4D. —Pathologically proven hepatic abscess in 59-year-old man. CT during hepatic arteriography image shows segmental enhancement (Arrowheads).

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