Pyogenic liver abscess ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

The ultrasound findings include round or oval shape, hypoechoic appearance with fine and homogeneous echoes, gas bubbles within the abscess, and absence of central perfusion on color doppler.[1][2][3]

Ultrasound

The ultrasound findings include:[1][2][3]

  • Round or oval shape
  • Hypoechoic appearance with fine and homogeneous echoes
  • Gas bubbles may be seen
  • Absence of central perfusion on color doppler

Contrast Enhanced Ultrasound

  • Enhancement during arterial phase and progressive washout during portal or late phases
  • The liquefied necrotic area does not enhance.

Advantages

  • The lesion may appear solid and mimic a hepatic tumor, in patients with monomicrobial K. pneumoniae abscesses.
  • The use of contrast allows us to measure the size of the necrotic area, characterize the lesion, and to depict internal septations for management purposes.
  • In highly septated abscesses and in small abscesses (under 3 cm) drainage is not recommended.

Pyogenic liver abscess

References

  1. 1.0 1.1 Ralls PW, Barnes PF, Radin DR, Colletti P, Halls J (1987). "Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison". AJR Am J Roentgenol. 149 (3): 499–501. doi:10.2214/ajr.149.3.499. PMID 3303877.
  2. 2.0 2.1 https://radiopaedia.org/articles/hepatic-abscess-1 Accessed on February 26, 2017
  3. 3.0 3.1 Hui JY, Yang MK, Cho DH, Li A, Loke TK, Chan JC; et al. (2007). "Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings". Radiology. 242 (3): 769–76. doi:10.1148/radiol.2423051344. PMID 17325065.