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J Korean Radiol Soc. 1988 Aug;24(4):637-644. Korean. Original Article. https://doi.org/10.3348/jkrs.1988.24.4.637
Kim HJ , Kim SS , Huh JD , Chun BH , Joh YD , Lee CH , Lee SD , Seo JK .
Abstract

For the evaluation of the role of CT in diagnosis and treatment of hepatic abscess, authors reviewed 50computed tomographic scans in 45 patients of comfirmed hepatic abscess retrospectively. The results were asfollows 1. The hepatic abscesses were caused by pyogenic infections in 34 patients (76%), amebic infections infive (11%), mixed infections in six(13%), the most common bacteria responsible for infection were E-coli(53%). 2.Predisposing facters could be identified in 26 cases, including biliary tract disease, intraadominal surgerypancreatitis. 3. Multiple lesions were found in 48%. 4. Multiloculations within single cavity were present in 32%,in 2 cases, finer multiloculation was seen. 5, Calcification in the abscess wall was seen in 3 cases. 6.Previously reported "highly suspected abscess findings" such as gas within lesion, rim enhancement and doubletarget sign were seen in 14%, 26%, 6% respectively. 7. The CT appearance of hepatic abscess was variable, so weclassified them 4 patterns. Ia type(30%): A hypodense central area surrounded by less hypodense zone were seen onprecontrast scan. Following contrast media infusion, the central hypodense area became nonenhancing well definedhypodense area and the peripheral hypodense zone became isodense with liver parencyma. Ib type(8%): A hypodensecentral area surrounded by less hypodense rim was seen on precontrast scan. Following contrast media infusion,they showed double target appearance. II type(24%): Poorly defined hypodense area was seen on precontrast scan.Following contrast media infusion, the center of the hypodense area became a well defined non-enhancing hypodensearea, and the periphery of the lesion became isodense with liver parenchyma, so the lesion became smaller in sizeon post-contrast scan. III type(38%): A relative well demarcated hypodense area on precontrast scan. Followingcontrast media infusion, they shows better demarcation and contrast with liver parenchyma. Almong these, well defined inner margin of the lesion on post contrast study is the most frequent and common CT appearance of hepaticabscess. 8. Thickening of peritoneum and chest wall or focal fluid collelction in peritoneal cavity was seen in60%. 9. Associated pleural effusion was seen in 70%. In conclusion, the CT scan was not only helpful for thedetection and diagnosis of hepatic abscess, but also for the management of the hepatic abscess since the CT scanwas very effective in the evaluation of the size, number, shape, position, presence of multiloculation, maturity of the abscess and associated disease.

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