Hepatic infarcts: new observations by CT and sonography

Area of Science:

• Radiology
• Hepatology
• Pathology

Background:

• Hepatic infarcts were historically diagnosed late, often post-mortem, with a near-fatal outcome.
• Recent advancements enable pre-autopsy diagnosis through advanced imaging modalities.

Purpose of the Study:

• To describe the diagnostic imaging features of hepatic infarcts.
• To highlight the variability in appearance and potential complications of hepatic infarcts.

Main Methods:

• Case series involving four patients with hepatic infarcts.
• Diagnostic imaging included computed tomography (CT), sonography, arteriography, and liver-spleen scans.

Main Results:

• Three of four patients survived, with diagnoses made via imaging.
• Imaging revealed round or oval, centrally located lesions, with some peripheral, wedge-shaped ones.
• Early lesions appeared hypoechoic (sonography) or low-density (CT); later lesions became confluent.
• New findings include bile lakes and gas formation within sterile infarcts.

Conclusions:

• Hepatic infarcts can be diagnosed and managed non-fatally with modern imaging.
• The variable appearance on CT and sonography necessitates careful differentiation from abscess or necrotic neoplasms.