title: Unusual enhancement pattern of liver lesions in hepatosplenic candidiasis.
abstract: OBJECTIVE
  To describe an unusual enhancement pattern of hepatosplenic candidiasis (HSC) liver lesions in biphasic spiral liver computed tomography (CT).
  
  
  METHODS
  Twenty-one patients with suspected HSC were scanned with a biphasic liver CT perfusion protocol. The liver lesions detected were assessed for their morphology and enhancement pattern during both perfusion phases. A liver biopsy was performed in 11/21 patients.
  
  
  RESULTS
  The majority of hepatic lesions in 15/21 patients showed the well-known abscess-like pattern. In 6/21 patients an uncommon central contrast enhancement with a peripheral double ring was detected in the arterial phase. In some cases the lesions showed decreased diameter or even seemed to disappear completely in the portalvenous phase.
  
  
  CONCLUSIONS
  CT in the arterial phase showed an unusual enhancement pattern of liver lesions in HSC. Scanning only in the portalvenous phase implies possible pitfalls, because lesions may be overlooked or undersized. Therefore, biphasic liver CT is considered essential in the diagnosis and follow-up of HSC in clinical practice.
authors.affiliation: Department of Radiology, Charité Campus Mitte, Medical Faculty of Humboldt University Berlin, Berlin, Germany. jens.rudolph@charite.de
authors.forename: J
authors.initials: J
authors.lastname: Rudolph
authors.forename: J
authors.initials: J
authors.lastname: Rodenwaldt
authors.forename: M
authors.initials: M
authors.lastname: Ruhnke
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: L
authors.initials: L
authors.lastname: Kopka
mesh_terms: D000328:Adult; D002177:Candidiasis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D013158:Splenic Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*