Imaging evaluation and management of liver infections: a multimodality review

Liver infections comprise a large category of hepatic diseases which vary in etiology and geographic distribution. They remain a significant cause of morbidity and mortality globally and require prompt diagnosis and management. Because clinical and laboratory findings may not be definitive, imaging often plays an important role in the diagnosis, characterization, and follow-up of hepatic infections. Advanced imaging techniques increase accuracy of diagnosis of specific infectious pathogens and in some cases provide the means of differentiation of various infections from other hepatic pathologies and conditions, most notably, neoplasms. Radiologists must be familiar with the key imaging findings and differential features in the multimodality approach to these conditions. This review provides a comprehensive overview of common and uncommon hepatic infections, highlighting key imaging features, characteristic signs, differential diagnoses, complications, and treatment considerations. Advanced techniques utilizing major cross-sectional modalities, including but not limited to contrast-enhanced ultrasound, dual energy computed tomography, and diffusion-weighted and contrast-enhanced magnetic resonance imaging will be discussed. A summary table that combines clinical, laboratory, demographic data and imaging findings will also be provided to guide diagnostic evaluation. This article aims to equip radiologists with essential tools for accurate diagnosis and timely clinical guidance.