The Infected Liver: Radiologic-Pathologic Correlation

Mortelé, Koenraad J.; Segatto, Enrica; Ros, Pablo R.

doi:10.1148/rg.244035719

Cited by 339 publications

(238 citation statements)

References 49 publications

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“…These small cysts are typically observed only in polycystic liver disease and should not be confused with the segmental biliary dilatations occasionally observed in the case of metastasis or macronodular cirrhosis, which are less regular and never adjacent to the main ducts [32] . Multiple hepatic pyogenic microabscesses are easy to differentiate from metastasis by clinical symptoms and the presence of a late faint enhancing peripheral rim on CT scan and MRI [33] . This rim is quite different from the early arterial enhancing ring observed in the case of metastasis.…”

Section: Multiple Cystic Tumorsmentioning

confidence: 99%

Cystic tumors of the liver: A practical approach

Poggio¹,

Buonocore²

2008

WJG

113

110

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Biliary cyst tumors (cystadenoma and cystadenocarcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver, but differential diagnosis with multiloculated or complicated biliary cysts, atypical hemangiomas, hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography (CT) and magnetic resonance imaging (MRI) are often not diagnostic and in these cases fine needle aspiration (FNA) is used to confirm the presence of atypical biliary cells. FNA, however, lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation o f c y s t a d e n o m a f r o m c y s t a d e n o c a r c i n o m a i s impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma, it is important to exclude liver metastasis, of which colonic cancer is the most common primary site. Multiple biliary hamartomas (von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic, but occasionally a percutaneous biopsy may be required.

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Section: Multiple Cystic Tumorsmentioning

confidence: 99%

Cystic tumors of the liver: A practical approach

Poggio¹,

Buonocore²

2008

WJG

113

110

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“…After anti-amebic treatment, 47 the lesion tends to become more hypoechoic and the margins become better defined. 48,49 Serology can support the diagnosis when available; US-guided aspiration shows material of necrotic hepatocytes ("anchovy sauce") typical in amebic abscesses. Diagnosis does usually not require aspiration.…”

Section: Other Infectious Diseases With Potential For Pocus Applicationmentioning

confidence: 99%

Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

Bélard¹,

Tamarozzi²,

Bustinduy³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. The development of good quality and affordable ultrasound machines has led to the establishment and implementation of numerous point-of-care ultrasound (POCUS) protocols in various medical disciplines. POCUS for major infectious diseases endemic in tropical regions has received less attention, despite its likely even more pronounced benefit for populations with limited access to imaging infrastructure. Focused assessment with sonography for HIV-associated TB (FASH) and echinococcosis (FASE) are the only two POCUS protocols for tropical infectious diseases, which have been formally investigated and which have been implemented in routine patient care today. This review collates the available evidence for FASH and FASE, and discusses sonographic experiences reported for urinary and intestinal schistosomiasis, lymphatic filariasis, viral hemorrhagic fevers, amebic liver abscess, and visceral leishmaniasis. Potential POCUS protocols are suggested and technical as well as training aspects in the context of resourcelimited settings are reviewed. Using the focused approach for tropical infectious diseases will make ultrasound diagnosis available to patients who would otherwise have very limited or no access to medical imaging.

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“…The characteristic imaging features of PLAs were regarded as follows: (a) solitary or multiple lesions tending to coalesce focally, (b) usually well-defined hypoattenuating lesions with faint rim enhancement and perilesional edema by contrast-enhanced CT, (c) unilocular with smooth margins or multilocular with septations and an irregular contour, (d) varying degrees of internal contents depending on the stage of suppuration, liquefaction, and fibrosis, and (e) occasionally containing gas in the lesions [21].…”

Section: Diagnosis Of Plamentioning

confidence: 99%

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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Background: Percutaneous catheter drainage (PCD) is currently the preferred therapeutic procedure of pyogenic liver abscesses (PLAs). However, multilocular poorly liquefied PLAs (MPLPs) are unsuitable for PCD. As reports on MPLPs are scarce, we aimed to explore possible therapeutic strategies for this serious type of PLA. Methods:The medical records of patients with PLA who were hospitalized at our institution between January 2011 to December 2015 were retrospectively reviewed. Demographic factors, biochemical, bacteriological, and imaging results, and treatment outcomes were evaluated.Results: Fourteen patients with MPLPs and 37 with drainable PLAs were identified and included in the study. Clinical characteristics were generally similar between the two groups. Klebsiella pneumoniae accounted for the majority of the culprit pathogens in MPLPs. Patients with MPLPs were managed medically without PCD. Despite this, treatment outcomes were not inferior compared to patients with drainable PLAs. Contrast-enhanced images revealed that the intricate septa of the MPLP maintained its blood perfusion. Most MPLPs did not liquefy over the treatment period. Conclusion:We should remember that MPLP is not rare. The septa may have delivered antibiotics adequately into the MPLPs, thus producing good treatment outcomes. Despite our findings, a high level of suspicion of treatment failure is crucial in these patients to ensure favorable treatment outcomes.

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The Infected Liver: Radiologic-Pathologic Correlation

Cited by 339 publications

References 49 publications

Cystic tumors of the liver: A practical approach

Cystic tumors of the liver: A practical approach

Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

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