EURORAD ESR

Case 12245

Solid organizing abscess of the liver

Author(s)
Sergio Savastano, Davide Dal Borgo, Lorenzo Di Grazia, Alessandra Costantini, Stefano Trupiani, Leonardo Giarraputo

U.O. Radiologia
Ospedale San Bortolo
V.le F. Rodolfi 37
36100 Vicenza, Italy
 
Patient
male, 52 year(s)
 
 
  • Figure 1
    MRI of the liver (Dec-2014)
     

    Axial T2w-MRI: marked dilatation of intrahepatic biliary ducts and pneumobilia.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    Axial T2w-MRI: intrahepatic biliary stones in the right lobe.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    Thick-slab MR-CP: stenosis of choledochojejunostomy and dilatation of intrahepatic biliary ducts containing multiple stones.

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;

    Axial CE-3D GE: portal cavernoma and hepatofugal collaterals.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 2
    MRI of the liver (Oct-2014)
     

    Axial T1 GE MRI: ovoid hypointense mass-like lesion of 2.5x5 cm in S4.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;

    Axial T2w-FS-MRI: the lesion is isointense to the liver but circumscribed by irregular hyperintense rim.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 3
    DW-MRI (Oct-2014)
     

    DWI b800

     
    Area of Interest: Liver; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Abscess;

    ADC map: no significant water restriction of the hepatic lesion (ADC value 1098/mm2/sec; liver ADC value 997 mm2/sec). The rim has higher ADC value of rim (1788 mm2/sec)

     
    Area of Interest: Liver; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 4
    Dynamic CE-3D MRI with Gd-BOPTA (Oct-2014)
     

    Arterial phase: no significant enhancement of the hepatic pseudomass, circumscribed by a transient hepatic intensity attenuation.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;

    Late phase (5 min): high signal intensity of the rim; tiny colliquative foci are also evident.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;

    Hepatobiliary phase: no take up of the liver-specific contrast medium.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
Axial T2w-MRI: marked dilatation of intrahepatic biliary ducts and pneumobilia.
 
Axial T2w-MRI: intrahepatic biliary stones in the right lobe.
 
Thick-slab MR-CP: stenosis of choledochojejunostomy and dilatation of intrahepatic biliary ducts containing multiple stones.
 
Axial CE-3D GE: portal cavernoma and hepatofugal collaterals.
 
Axial T1 GE MRI: ovoid hypointense mass-like lesion of 2.5x5 cm in S4.
 
Axial T2w-FS-MRI: the lesion is isointense to the liver but circumscribed by irregular hyperintense rim.
 
DWI b800
 
ADC map: no significant water restriction of the hepatic lesion (ADC value 1098/mm2/sec; liver ADC value 997 mm2/sec). The rim has higher ADC value of rim (1788 mm2/sec)
 
Arterial phase: no significant enhancement of the hepatic pseudomass, circumscribed by a transient hepatic intensity attenuation.
 
Late phase (5 min): high signal intensity of the rim; tiny colliquative foci are also evident.
 
Hepatobiliary phase: no take up of the liver-specific contrast medium.
 
 
 
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