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Dynamic CT of Acute Cholangitis: Early Inhomogeneous Enhancement of the Liver

Kazunori Arai1, Keiichi Kawai1, Wataru Kohda1,2, Hiroki Tatsu3, Osamu Matsui3 and Tooru Nakahama4

1 Department of Radiology, Kurobe City Hospital, 1108-1 Mikkaichi, Kurobe 938-0031, Japan.
2 Present address: Department of Radiology, Toyama City Hospital, 2-1 Imaizumihokubu, Toyama 939-8511, Japan.
3 Department of Radiology, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan.
4 Department of Gastro-Enterology, Kurobe City Hospital, Kurobe 938-0031, Japan.



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  		Fig. 1A. —62-year-old man with acute cholangitis caused by pancreatic cancer who was treated with biliary stent, endoscopic nasobiliary drainage, and antibiotic therapy. Early phase dynamic CT scans show marked patchy or nodular inhomogeneous enhancement throughout liver (grade 2).

 


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  		Fig. 1B. —62-year-old man with acute cholangitis caused by pancreatic cancer who was treated with biliary stent, endoscopic nasobiliary drainage, and antibiotic therapy. Early phase dynamic CT scans show marked patchy or nodular inhomogeneous enhancement throughout liver (grade 2).

 


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  		Fig. 1C. —62-year-old man with acute cholangitis caused by pancreatic cancer who was treated with biliary stent, endoscopic nasobiliary drainage, and antibiotic therapy. Follow-up early phase dynamic CT scan obtained after treatment for cholangitis shows inhomogeneous enhancement is no longer present (grade 0). Pneumobilia caused by biliary stent is seen.

 


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  		Fig. 2A. —70-year-old woman with acute cholangitis caused by pancreatic cancer treated with biliary stent and antibiotic therapy. Early phase dynamic CT scans show marked geographic or patchy inhomogeneous enhancement throughout liver (grade 2).

 


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  		Fig. 2B. —70-year-old woman with acute cholangitis caused by pancreatic cancer treated with biliary stent and antibiotic therapy. Early phase dynamic CT scans show marked geographic or patchy inhomogeneous enhancement throughout liver (grade 2).

 


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  		Fig. 2C. —70-year-old woman with acute cholangitis caused by pancreatic cancer treated with biliary stent and antibiotic therapy. Follow-up early phase dynamic CT scan obtained after treatment for cholangitis shows inhomogeneous enhancement is no longer present (grade 0). Pneumobilia caused by biliary stent can be seen.

 


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  		Fig. 3A. —56-year-old woman with acute cholangitis caused by gallstone who underwent antibiotic therapy. Early phase dynamic CT scans show nodular or patchy inhomogeneous enhancement (grade 1).

 


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  		Fig. 3B. —56-year-old woman with acute cholangitis caused by gallstone who underwent antibiotic therapy. Early phase dynamic CT scans show nodular or patchy inhomogeneous enhancement (grade 1).

 


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  		Fig. 3C. —56-year-old woman with acute cholangitis caused by gallstone who underwent antibiotic therapy. Follow-up early phase dynamic CT scan obtained after treatment for cholangitis shows inhomogeneous enhancement is no longer present (grade 0).

 

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