Hepatic perivascular lymphedema: CT appearance

Koslin, D B; Stanley, Robert J.; Berland, Lincoln L.; Shin, Myung S.; Dalton, Susan

doi:10.2214/ajr.150.1.111

Cited by 54 publications

(23 citation statements)

References 2 publications

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“…This hypothesis was based on histologic examinations and was verified in animal model studies (7). Similar findings were later reported (5) in 18 patients where impaired hepatic lymphatic drainage was suggested. Peripheral periportal lucencies at CT of liver allografts have recently been reported, and proposed as a marker of acute allograft rejection (4,10).…”

supporting

confidence: 63%

Perivascular Low Attenuation Zone at CT of Liver Transplants

Aspestrand¹,

Mathisen²,

Bergan³

1991

Acta Radiol

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A follow-up study of 30 liver transplant patients confirmed that periportal and pericaval rims oflow attenuation found at CT reflect hepatic lymph stasis. The perivascular rims are found coexistent with acute allograft rejection, but are not correlated with acute rejection, immunosuppressive agents (cyclosporin A), or intercurrent infection. Disappearance of the perivascular low attenuation zone in our materialcoincided with normalization ofliver biochemistry probably associated with reestablishment of lymphatic drainage. Like previous reports on experimental hepatic lymph stasis, our study thus indicates that lymph stasismay have harmful effects on human liver allografts.

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supporting

confidence: 63%

Perivascular Low Attenuation Zone at CT of Liver Transplants

Aspestrand¹,

Mathisen²,

Bergan³

1991

Acta Radiol

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“…Until recently, there was only sporadic reports on cases of patients with acute pyelonephritis and gallbladder wall thickening or perivascular fluid (13) and periportal edema (14,15) . Periportal edema had already been described for other conditions such as cirrhosis, hepatitis, liver tumors, biliary tract obstruction, liver and bone marrow transplant, heart failure, abdominal trauma in the pediatric population (14,(23)(24)(25) , and even in acute pyelonephritis (7,15) . In the present study this was a relatively frequent finding, present in one-third of cases.…”

Section: Discussionmentioning

confidence: 92%

Freqüência dos sinais de pielonefrite aguda em pacientes submetidos a tomografia computadorizada

et al. 2007

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OBJECTIVE: The present study was aimed at establishing the frequency of renal/perirenal and extrarenal computed tomography findings in patients with acute pyelonephritis, and evaluating the interobserver agreement. MATERIALS AND METHODS: Retrospective study based on the analysis of computed tomography images of 47 patients with clinical and laboratory findings of acute pyelonephritis. Two independent observers evaluated the main renal/perirenal and extrarenal alterations. The frequency of tomographic findings and interobserver agreement were analyzed by the kappa (κ κ κ κ κ) test. RESULTS: The frequency of tomographic findings for the several parameters was the following: striated nephrogram, 100%; renal enlargement, 65%; perirenal fat heterogeneity, 62.5%; renal calculi, 16.6%; abscesses, 21%; pleural effusion, 36%; thickened gallbladder wall, 32.5%; periportal edema, 32.5%. The κ κ κ κ κ test for interobserver agreement demonstrated reproducibility ranging between moderate (κ κ κ κ κ = 0.511 for renal enlargement) to almost perfect (κ κ κ κ κ = 0.87 for striated nephrogram) for all of the parameters analyzed, except for perirenal fat heterogeneity (κ κ κ κ κ = 0.268).CONCLUSION: The frequency of findings of acute pyelonephritis on computed tomography is high. Overall, striated nephrogram was the most frequent finding. Peri-and extra-renal alterations were found in about 2/3 of the cases. Computed tomography demonstrated a good interobserver agreement. Keywords: Acute pyelonephritis; Kidney; Computed tomography; Reproducibility.Freqüência dos sinais de pielonefrite aguda em pacientes submetidos a tomografia computadorizada. OBJETIVO: Estimar a freqüência das alterações tomográficas renais e extra-renais em pacientes com pielonefrite aguda e avaliar o grau de concordância interobservador. MATERIAIS E MÉTODOS: Realizamos trabalho retrospectivo a partir da análise dos exames de tomografia computadorizada de 47 pacientes com diagnóstico clínico e laboratorial de pielonefrite aguda. Dois examinadores independentes avaliaram as principais alterações renais, perirrenais e extra-renais. Foi medida a freqüência dos achados tomográficos e a concordância interobservador por meio do teste kappa (κ κ κ κ κ). RESULTADOS: A freqüência dos achados tomográficos para os diversos parâmetros estudados foi: nefrograma heterogêneo, 100%; nefromegalia, 65%; heterogeneidade da gordura, 62,5%; nefrolitíase, 16,6%; abscessos, 21%; derrame pleural, 36%; espessamento da vesícula biliar, 32,5%; edema periportal, 32,5%. O teste κ κ κ κ κ para a concordância interobservador demonstrou reprodutibilidade variando entre moderada (κ κ κ κ κ = 0,511 para nefromegalia) e quase perfeita (κ κ κ κ κ = 0,87 para nefrograma heterogêneo) para todos os parâmetros estudados, exceto para a heterogeneidade da gordura perirrenal (κ κ κ κ κ = 0,268). CONCLUSÃO: A freqüência dos diversos achados tomográficos de pielonefrite aguda é elevada, sendo o nefrograma heterogêneo o sinal mais comum. Alterações perinefréticas e extra-renais são observadas em até dois te...

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“…Furthermore, zones of PPE have been associated with hepatic disorders like hepatitis, bile duct proliferation, perivascular inflammation following bone marrow, or liver transplantation or congestive heart failure, which may lead to an increased venous pressure (3). Koslin et al described intrahepatic perivascular hypodense zones in 12 patients suffering from cardiac decompensation and consecutive hepatomegaly causing an increased venous pressure engendering enhanced fluid formation in the hepatic interstitial compartment (9,15).…”

Section: Discussionmentioning

confidence: 99%