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Multiple actinomycotic liver abscesses: MRI appearances with etiology suggested by abdominal radiography. Case report
L N Nazarian1, J A Spencer, D G Mitchell
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244.
Abstract:
The magnetic resonance imaging appearances of multiple actinomycotic liver abscesses are described. The abscesses appeared hypointense to liver parenchyma on T1-weighted sequences and hyperintense on T2-weighted sequences with some surrounding edema. Following intravenous gadolinium diethylenetriamine-pentaacetic acid, the masses showed a thick enhancing rim but no central enhancement. Although no etiology was discovered in the initial clinical history, antecedent dental surgery was evident on abdominal radiography that depicted dental amalgam in the ascending colon.
Insights
Multiple actinomycotic liver abscesses present distinct magnetic resonance imaging (MRI) features. These abscesses show specific signal intensities and rim enhancement patterns on MRI, aiding diagnosis.
Area of Science:
- Radiology
- Infectious Diseases
- Medical Imaging
Background:
- Actinomycosis is a rare bacterial infection often caused by Actinomyces species.
- Liver involvement in actinomycosis is uncommon, presenting diagnostic challenges.
Observation:
- Multiple liver abscesses were visualized using magnetic resonance imaging (MRI).
- Abscesses exhibited hypointensity on T1-weighted and hyperintensity on T2-weighted MRI sequences.
- Perilesional edema was noted surrounding the abscesses.
Findings:
- Post-contrast MRI revealed a thick, enhancing rim with absent central enhancement in the abscesses.
- Abdominal radiography identified dental amalgam in the ascending colon, suggesting a link to antecedent dental surgery.
- The imaging findings are characteristic of actinomycotic liver abscesses.
Implications:
- MRI is crucial for characterizing actinomycotic liver abscesses.
- Identifying dental amalgam can provide etiological clues for liver actinomycosis.
- Radiological findings can guide clinical suspicion and management of this rare infection.