title: Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome.
abstract: OBJECTIVE
  To analyze multidetector computed tomographic (MDCT) parameters in patients with pyogenic liver abscess (PLA), and to identify which parameters can be predicted percutaneous catheter drainage (PCD) treatment outcome.
  
  
  METHODS
  Clinical, laboratory and MDCT findings of 175 patients with PLA who had undergone PCD were retrospectively reviewed. All abscesses shown on MDCT were evaluated for size, margin, attenuation values, location, number of large (>3cm) abscesses, presence of a cystic component, presence of gas, and the shortest length to the liver capsule. Univariate and multivariate analyses of the MDCT parameters that affect PCD treatment outcome was performed. For continuous data of MDCT parameters (abscess size and the shortest length), we used receiver-operating-characteristic (ROC) curve to determine the optimal cut-off values.
  
  
  RESULTS
  PCD was failed in 32 patients and the overall failure rate was 18.28%. Multivariate analysis revealed that PCD failure was predicted by the presence of gas (odds ratio [OR], 42.67), a large abscess (OR 1.21), low minimal attenuation values (OR 1.02), wide range of attenuation values (OR 1.01), a shorter length to the liver capsule (OR 0.09) and lack of a cystic component (OR 0.09) of the PLA. ROC curve showed that the shortest length less than 0.25cm and an abscess size greater than 7.3cm were the optimal cut-off values predicting PCD treatment failure.
  
  
  CONCLUSIONS
  Among these MDCT parameters, gas formation within PLA was the most important predictor for PCD failure. Surgical intervention might be considered early in high-risk patients of PCD failure.
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-I
authors.initials: WI
authors.lastname: Liao
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Tsai
authors.forename: Chih-Yung
authors.initials: CY
authors.lastname: Yu
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Yen-Yue
authors.initials: YY
authors.lastname: Lin
authors.forename: Ching-Wang
authors.initials: CW
authors.lastname: Hsu
authors.forename: Hsian-He
authors.initials: HH
authors.lastname: Hsu
authors.forename: Wei-Chou
authors.initials: WC
authors.lastname: Chang
mesh_terms: D002406:Catheterization, Peripheral / Q000379:methods*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult