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The Infected Liver: Radiologic-Pathologic Correlation¹

¹ From the Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham & Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115. Received July 31, 2003; revision requested October 3 and received January 2, 2004; accepted January 5. All authors have no financial relationships to disclose. Address correspondence to K.J.M. (e-mail: kmortele@partners.org).

Recent technologic advances have significantly enhanced the role of imaging in the detection, characterization, and management of infectious diseases involving the liver. In addition, imaging-guided percutaneous drainage has greatly improved the clinical treatment of patients with focal liver abscess. Infectious liver diseases can be accurately evaluated with ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging. Characteristic changes in US echogenicity, CT attenuation, or MR imaging signal intensity and typical enhancement patterns can contribute to the diagnosis of specific infectious diseases, including abscesses, parasitic diseases, fungal diseases, granulomatous diseases, viral hepatitis, and other less common infections. CT is particularly helpful in revealing the presence of calcifications and gas and in detailing the enhancement pattern. The multiplanar capability of MR imaging and its sensitivity to small differences in tissue composition increase its specificity for certain hepatic infections, including hydatid cyst and candidiasis. Radiologic findings may be sufficient to obviate aspiration or histologic examination, although in most instances they are less specific. Nevertheless, imaging findings taken together with appropriate clinical information may provide the most likely diagnosis, even if biopsy is sometimes required for confirmation.

© RSNA, 2004

Index Terms: Amebiasis, 761.2071 • Liver, abscess, 761.21 • Liver, CT, 761.1211 • Liver, cysts, 761.311 • Liver, diseases, 761.20, 761.2083, 761.21, 761.291 • Liver, echinococcosis, 761.2083 • Liver, infection, 761.20, 761.2083, 761.21, 761.291 • Liver, MR, 761.1214 • Liver, US, 761.1298

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