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28.11.2015 | Hepatobiliary-Pancreas

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

verfasst von: Maxime Ronot, Anne Kerbaol, Pierre-Emmanuel Rautou, Giuseppe Brancatelli, Pierre Bedossa, Dominique Cazals-Hatem, Dominique-Charles Valla, Valérie Vilgrain

Erschienen in: European Radiology | Ausgabe 9/2016

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Abstract

Purpose

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.

Conclusion

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.

Key Points

• 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.

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Titel: 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
verfasst von: Maxime Ronot
Anne Kerbaol
Pierre-Emmanuel Rautou
Giuseppe Brancatelli
Pierre Bedossa
Dominique Cazals-Hatem
Dominique-Charles Valla
Valérie Vilgrain
Publikationsdatum: 28.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4124-2

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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