Diagnostic imaging of hepatic abscesses: a retrospective analysis

Seventeen patients with pathologically proven intrahepatic abscesses seen over a 12 month period were retrospectively evaluated. Of these 17 patients, 16 had at least three of the four commonly used imaging techniques for the evaluation of hepatic abscesses, including scintigraphy with technetium-99m-labeled sulfur colloid and gallium-67 citrate, sonography, and computed tomography. Of the 17 abscesses, 12 were of pyogenic and five were of amebic origin. Technetium-99m sulfur colloid correctly identified 14 of 16 abscesses; gallium, nine of 10; sonography, 12 of 16; and computed tomography, 15 of 17. The rational approach to the diagnosis of intrahepatic abscesses should be a 99mTc sulfur colloid scan followed, if necessary, by either sonography or CT. In equivocal cases a gallium scan may be of value.