Orlando Catalano MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To illustrate the appearance of pyogenic liver abscess as shown during real-time, contrast-specific, harmonic ultrasound (US) imaging. To our knowledge, the contrast-specific US findings in pyogenic liver abscess have not been described yet. Methods and Materials: We retrospectively evaluated the contrast-specific US features of 8 cases of aspiration-confirmed liver abscess. There were 5 women and 3 men, aged 25-78 years. A continuous-mode, low-mechanical index US technology was employed (CnTI - Contrast Tuned Imaging, Esaote, Italy). A second-generation, sulfur-exafluoride based, microbubble contrast agent was injected I.V. (SonoVue, Bracco, Italy). All studies were correlated with the CT findings. Results: The following findings were categorized in 13 abscesses (1-6 abscess/patient, mean 1.6). Arterial-phase rim enhancement (13/13), arterial vessels running along the margin of the abscess (11/13), small arterioles within the internal septa (8/13), dense and persistent septal enhancement (13/13), absent microcirculation within the internal fluid/necrotic components (13/13), periabscessual transitory arterial-phase hypervascularity (perifocal hyperemia, 3/13). Larger abscesses showed partial peripheral septa while thin but complete septa could be identified in smaller abscesses, with an overall appearance of honeycombing. Conclusion: Contrast-specific US allows detection of typical features of hepatic pyogenic abscess, including: arterial-phase rim enhancement, arterial vessels running along the margin of the abscess or the internal septa, dense and persistent septal enhancement, absent microcirculation within the internal fluid/necrotic components, periabscessual transient arterial-phase hypervascularity. Radiologist should be aware of the typical and atypical appearance of hepatic pyogenic abscess as shown at contrast-specific US imaging.      

Catalano MD, O, Pyogenic Liver Abscess: Harmonic, Contrast-specific Ultrasound Imaging Findings.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3101776.html