title: Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver.
abstract: OBJECTIVE
  To report the association of a mosaic enhancement pattern on contrast-enhanced CT or MR imaging and hepatic sinusoidal dilatation (SD) with acute inflammatory conditions affecting extrahepatic organs.
  
  
  METHODS
  From 2007 to 2012, patients with acute inflammatory diseases who underwent contrast-enhanced CT and/or MRI of the liver with a mosaic enhancement pattern were selected. Clinico-biological and other imaging features were collected at diagnosis and during follow-up.
  
  
  RESULTS
  Sixteen patients were included (15 women, median age 27 years; range 18-68). Five women (33 %) were receiving oral contraceptives. Acute inflammatory diseases included pyelonephritis (n = 10), pancreatitis (n = 2), pneumonia (n = 1), septicemia (n = 1), active Crohn's disease (n = 1), and infectious colitis (n = 1). Median white blood cell count was 13,250 cells/μL (range 11,500-18,000 cells/μL) and CRP level 94 mg/L (range 60-121 mg/L). Mosaic enhancement pattern was present in the whole liver and was prominent in the subcapsular areas. Four patients underwent liver biopsy confirming SD. Eleven patients underwent follow-up imaging showing normalized aspect in 9/11 patients after a median of 2 months.
  
  
  CONCLUSIONS
  Acute diseases of extrahepatic organs, associated with a marked systemic inflammatory syndrome should be added to the list of conditions causing a reversible hepatic sinusoidal dilatation as manifested by a mosaic enhancement pattern on contrast-enhanced CT or MR imaging.
  
  
  CONCLUSIONS
  • Acute extrahepatic infectious/inflammatory diseases are a cause of transient MP. • In most patients, MP was seen during both arterial and portal venous phase. • In all patients, the mosaic enhancement pattern was diffuse, but more conspicuous in subcapsular areas. • MP was no longer seen after resolution of the acute disease. • No liver biopsy should be performed.
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon Hospital, Hauts-de-Seine, 100 bd general Leclerc, 92118, Clichy, France. maxime.ronot@bjn.aphp.fr.|University Paris Diderot, Sorbonne Paris Cité, Paris, France. maxime.ronot@bjn.aphp.fr.|INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France. maxime.ronot@bjn.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon Hospital, Hauts-de-Seine, 100 bd general Leclerc, 92118, Clichy, France.|University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Kerbaol
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France.|Department of Hepatology and DHU Unity, University Hospitals Paris Nord Val de Seine, Beaujon, Hauts-de-Seine, Clichy, France.
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Rautou
authors.affiliation: Section of Radiology, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brancatelli
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France.|INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France.|Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon, Hauts-de-Seine, Clichy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.affiliation: Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon, Hauts-de-Seine, Clichy, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Cazals-Hatem
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France.|Department of Hepatology and DHU Unity, University Hospitals Paris Nord Val de Seine, Beaujon, Hauts-de-Seine, Clichy, France.
authors.forename: Dominique-Charles
authors.initials: DC
authors.lastname: Valla
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon Hospital, Hauts-de-Seine, 100 bd general Leclerc, 92118, Clichy, France.|University Paris Diderot, Sorbonne Paris Cité, Paris, France.|INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D004108:Dilatation, Pathologic / Q000473:pathology; D005260:Female; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D007239:Infections / Q000473:pathology; D007249:Inflammation / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Computed tomography; Inflammation and infection; Magnetic resonance imaging; Mosaic enhancement pattern; Sinusoidal dilatation