title: Magnetic resonance imaging is superior to computed tomography and ultrasonography in imaging infectious liver foci in acute leukaemia.
abstract: We conducted a prospective study in order to compare ultrasonography, computed tomography and magnetic resonance imaging in the detection of liver foci in patients with acute leukaemia and clinical suspicion of hepatic candidiasis. 28 adult patients fulfilling set entry criteria after recovery from neutropenia were studied. Lesions in the liver were detected by at least one imaging modality in 21 patients: by ultrasonography in 7 (33% of detected cases), computed tomography in 12 (57%) and by magnetic resonance imaging in 20 patients (95%). Magnetic resonance imaging was significantly more sensitive than ultrasonography (p<0.001) and computed tomography (p<0.02). The difference between computed tomography and ultrasonography was not statistically significant (p=0.1). Invasive procedures performed in 10 patients provided definite proof of candidiasis in 5 patients, and nodes on the liver surface, compatible with yeast infection, were seen during laparoscopy in 3 other patients without proof of fungal infection. We confirm that magnetic resonance imaging is superior to ultrasonography and computed tomography in imaging liver foci in leukaemic patients recovering from neutropenia with persistent non-specific signs of infection or hepatic involvement.
authors.affiliation: Department of Medicine, University of Helsinki, Finland.
authors.forename: V J
authors.initials: VJ
authors.lastname: Anttila
authors.forename: A E
authors.initials: AE
authors.lastname: Lamminen
authors.forename: S
authors.initials: S
authors.lastname: Bondestam
authors.forename: O
authors.initials: O
authors.lastname: Korhola
authors.forename: M
authors.initials: M
authors.lastname: Färkkilä
authors.forename: A
authors.initials: A
authors.lastname: Sivonen
authors.forename: T
authors.initials: T
authors.lastname: Ruutu
authors.forename: P
authors.initials: P
authors.lastname: Ruutu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D002177:Candidiasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002423:Cause of Death; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents