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Hepatic abscesses: MR imaging findings
R J Méndez1, M L Schiebler, E K Outwater
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia.
Purpose:
To determine magnetic resonance (MR) imaging features that characterize hepatic abscesses.
Materials And Methods:
Clinical records and MR studies of 18 patients with proved hepatic abscesses were evaluated. The abscesses were pyogenic in 15 patients, fungal in two patients, and amebic in one patient.
Results:
A total of 122 lesions were identified. Most were round (n = 114) with sharp borders (n = 99), hypointense on T1-weighted images (n = 73), and very hyperintense on T2-weighted images (n = 88). After injection of gadopentetate dimeglumine in 43 lesions, all 43 enhanced with sharp margins and 37 showed rim enhancement. All abscesses followed up diminished in size (50 of 50), and perilesional edema resolved before the central cavity did.
Conclusion:
MR imaging findings seen in hepatic abscesses include high signal intensity on T2-weighted images (72%) and perilesional edema (43 of 122 [35%]). Rim enhancement (86%) and increased conspicuity (35 of 43 [81%]) were found after injection of gadopentetate dimeglumine.
Insights
Magnetic resonance (MR) imaging helps characterize hepatic abscesses. Key findings include high T2-weighted signal intensity and rim enhancement after gadopentetate dimeglumine injection.
Area of Science:
- Radiology
- Medical Imaging
Background:
- Hepatic abscesses are collections of pus within the liver.
- Accurate characterization is crucial for effective treatment.
Purpose of the Study:
- To identify magnetic resonance (MR) imaging features that characterize hepatic abscesses.
- To correlate imaging findings with abscess etiology.
Main Methods:
- Retrospective review of MR imaging studies and clinical records of 18 patients with proven hepatic abscesses.
- Analysis of lesion morphology, signal intensity on T1- and T2-weighted images, and enhancement patterns after gadolinium-based contrast administration.
- Categorization of abscesses by etiology: pyogenic, fungal, and amebic.
Main Results:
- 122 lesions were analyzed. Most were round with sharp borders.
- Abscesses typically appeared hypointense on T1-weighted and hyperintense on T2-weighted images.
- Post-contrast imaging revealed sharp margins and rim enhancement in most lesions. Perilesional edema was a common finding.
Conclusions:
- MR imaging findings, including high T2 signal intensity and perilesional edema, are characteristic of hepatic abscesses.
- Gadopentetate dimeglumine administration enhances lesion conspicuity and demonstrates rim enhancement, aiding diagnosis.
- MR imaging is a valuable tool for diagnosing and characterizing hepatic abscesses.