Hepatic attenuation differences associated with obstruction of the portal or hepatic veins in patients with hepatic abscess.
OBJECTIVE
The purpose of our study was to determine the nature of the association between the attenuation difference of the hepatic parenchyma surrounding an abscess and obstruction of the regional portal vein or of the hepatic vein.


METHODS
Helical CT scans of 60 patients with hepatic abscess were analyzed for the presence of complete or partial obstruction of the portal or hepatic veins and for attenuation differences in the surrounding parenchyma. Clinical (age, sex, underlying disease, and microorganism) and CT (obstruction of the portal or hepatic vein and number, location, and size of abscesses) findings were analyzed statistically for possible associations with each of regional parenchymal hyper- and hypoattenuation by using the chi-square test and multivariate logistic regression analysis.


RESULTS
Regional parenchymal hyperattenuation was identified in 40 patients (67%). More patients with portal vein obstruction showed regional parenchymal hyperattenuation than patients without portal vein obstruction (22/27 patients vs 18/33, p = 0.028), and more patients with hepatic vein obstruction showed regional parenchymal hypoattenuation than those without hepatic vein obstruction (11/21 vs 3/39, p = 0.0003). Multivariate logistic regression analysis showed that portal venous obstruction was the only statistically significant predictor of regional parenchymal hyperattenuation (p = 0.032; odds ratio, 3.7) and that parenchymal hypoattenuation was associated with hepatic venous obstruction (p = 0.001; odds ratio, 44.9).


CONCLUSIONS
Parenchymal hypo- and hyperattenuation are frequently observed in the hepatic region surrounding an abscess on dynamic CT. Moreover, these parenchymal attenuation differences are associated with regional portal or hepatic vein obstruction.
Lee
Kyoung Ho
KH
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Korea.
Han
Joon Koo
JK
Jeong
Jun Yong
JY
Kim
Young Jun
YJ
Lee
Hak Jong
HJ
Park
Seong Ho
SH
Choi
Byung Ihn
BI
D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000473:pathology; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000473:pathology; D036542:Tomography, Spiral Computed