EURORAD ESR

Case 15047

Amebic liver abscess: MRI findings

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
male, 41 year(s)
 
 
  • Figure 1
    Ultrasound
     

    Sonography revealed a large well-demarcated ovoid hypoechoic mass (calipers) located in the dorsal aspect of the right liver lobe, measuring approximately 8x5.5 cm, which caused mild ventral dislocation of the portal...

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

    The well-demarcated ovoid hypoechoic mass (calipers) measured approximately 8x5.5 cm and had no perceptible wall. Moderately enlarged liver with otherwise unremarkable echotexture.

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

    The well-demarcated ovoid hypoechoic mass (calipers) had no perceptible wall nor intralesional signal at color-Doppler ultrasound (c), and caused compression on the inferior vena cava and mild ventral dislocation of...

     
    Area of Interest: Liver; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 2
    Unenhanced and dynamic contrast-enhanced upper abdominal MRI
     

    T2-weighted images (a-b, fat-suppressed c) confirmed sizeable mass (*) in the dorsal aspect of right liver lobe, with internal fluid-like hyperintense signal, thin low-signal contour (arrows).

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

    The sizeable, well-demarcated mass (*) in the dorsal aspect of right liver lobe showed internal fluid-like hyperintense signal, thin low-signal contour (arrows) and mild oedema (arrows) of the adjacent parenchyma....

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Image compression; Special Focus: Abscess;

    The sizeable, well-demarcated mass (*) in the dorsal aspect of right liver lobe showed internal fluid-like hyperintense signal, thin low-signal contour (arrows) and mild oedema (arrows) of the adjacent parenchyma....

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

    On precontrast T1-weighted images (d,e) the right liver lobe mass (*) showed homogeneous, fluid-like low signal intensivy; a thin regular peripheral rim (thin arrows) with intermediate signal intensity was clearly...

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

    On precontrast T1-weighted images (d,e) the right liver lobe mass (*) showed homogeneous, fluid-like low signal intensivy; a thin regular peripheral rim (thin arrows) with intermediate signal intensity was clearly...

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

    High (800) b-value diffusion-weighted images showed the lesion (*) to have inhomogeneous, visually hyperintense signal which was more pronounced at the periphery (thin arrows).

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

    Corresponding apparent diffusion coefficient (ADC) map showed strong peripheral hypointensity (measured values 0.25-0.35x10-3mm2/s), moderately restricted diffusion centrally (*, mean 0.9x10-3mm2/s).

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

    After intravenous gadolinium contrast, the lesion (*) did not enhance centrally; a moderately thick uniform peripheral rim of enhancement (thin arrows) was best visible in the arterial-dominant (h) compared to the...

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

    After intravenous gadolinium contrast, the lesion (*) did not enhance centrally; a moderately thick uniform peripheral rim of enhancement (thin arrows) was best visible in the arterial-dominant (h) compared to the...

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
Sonography revealed a large well-demarcated ovoid hypoechoic mass (calipers) located in the dorsal aspect of the right liver lobe, measuring approximately 8x5.5 cm, which caused mild ventral dislocation of the portal vein.
 
The well-demarcated ovoid hypoechoic mass (calipers) measured approximately 8x5.5 cm and had no perceptible wall. Moderately enlarged liver with otherwise unremarkable echotexture.
 
The well-demarcated ovoid hypoechoic mass (calipers) had no perceptible wall nor intralesional signal at color-Doppler ultrasound (c), and caused compression on the inferior vena cava and mild ventral dislocation of the portal vein.
 
T2-weighted images (a-b, fat-suppressed c) confirmed sizeable mass (*) in the dorsal aspect of right liver lobe, with internal fluid-like hyperintense signal, thin low-signal contour (arrows).
 
The sizeable, well-demarcated mass (*) in the dorsal aspect of right liver lobe showed internal fluid-like hyperintense signal, thin low-signal contour (arrows) and mild oedema (arrows) of the adjacent parenchyma. Note compressed inferior vena cava (arrowheads).
 
The sizeable, well-demarcated mass (*) in the dorsal aspect of right liver lobe showed internal fluid-like hyperintense signal, thin low-signal contour (arrows) and mild oedema (arrows) of the adjacent parenchyma. Note compressed inferior vena cava (arrowheads).
 
On precontrast T1-weighted images (d,e) the right liver lobe mass (*) showed homogeneous, fluid-like low signal intensivy; a thin regular peripheral rim (thin arrows) with intermediate signal intensity was clearly perceptible.
 
On precontrast T1-weighted images (d,e) the right liver lobe mass (*) showed homogeneous, fluid-like low signal intensivy; a thin regular peripheral rim (thin arrows) with intermediate signal intensity was clearly perceptible.
 
High (800) b-value diffusion-weighted images showed the lesion (*) to have inhomogeneous, visually hyperintense signal which was more pronounced at the periphery (thin arrows).
 
Corresponding apparent diffusion coefficient (ADC) map showed strong peripheral hypointensity (measured values 0.25-0.35x10-3mm2/s), moderately restricted diffusion centrally (*, mean 0.9x10-3mm2/s).
 
After intravenous gadolinium contrast, the lesion (*) did not enhance centrally; a moderately thick uniform peripheral rim of enhancement (thin arrows) was best visible in the arterial-dominant (h) compared to the venous (i) phase.
 
After intravenous gadolinium contrast, the lesion (*) did not enhance centrally; a moderately thick uniform peripheral rim of enhancement (thin arrows) was best visible in the arterial-dominant (h) compared to the venous (i) phase.
 
 
 
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