Related Experiment Videos
Hepatic infarcts: new observations by CT and sonography
Insights
Diagnosing hepatic infarcts (liver tissue death) is now possible before autopsy using imaging. These imaging techniques reveal variable appearances, aiding in earlier detection of this serious condition.
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.
Abstract:
Until recently hepatic infarcts were rarely diagnosed before autopsy and were nearly always fatal. Four cases of hepatic infarcts, three of them nonfatal, were diagnosed and followed by CT (three cases), sonography (two cases), arteriography (two cases), and sulfur colloid liver-spleen scan (one case). In three patients with multiple subsegmental hepatic infarcts, most of the lesions were round or oval and centrally located. Only a minority of the lesions were wedge-shaped and peripheral. The early lesion appears hypoechoic on sonography, and CT shows a poorly demarcated low-density region. Later, lesions become confluent with more distinct margins. Bile lakes are a late sequela of large infarcts. Gas formation within sterile infarcts is newly described in two cases. Hepatic infarcts have a variable appearance on CT and sonography and are not reliably distinguished from other lesions such as abscess or necrotic neoplasm.