Multimodality imaging of liver infections: Differential diagnosis and potential pitfalls

Pablo Bächler, María José Baladron, Christine Menias, Ignacio Beddings, Ron Loch, Eugenio Zalaquett, Matías Vargas, Sarah Connolly, Sanjeev Bhalla, Álvaro Huete

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Imaging plays an important role in the diagnosis, characterization, and management of infectious liver disease. In clinical practice, the main contributions of imaging are in detecting early disease, excluding other entities with a similar presentation, establishing a definitive diagnosis when classic findings are present, and guiding appropriate antimicrobial, interventional, or surgical treatment. The most common imaging features of bacterial, viral, parasitic, and fungal hepatic infections are described, and key imaging and clinical manifestations are reviewed that may be useful to narrow the differential diagnosis and avoid pitfalls in image interpretation. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging allow accurate detection of most hepatic infections and, in some circumstances, may provide specific signs to identify the underlying pathogen and exclude other entities with similar imaging features. In bacterial and parasitic infections, specific imaging features may be enough to exclude a neoplasm and, occasionally, to identify the underlying infectious agent. US and CT are important means to guide percutaneous aspiration or drainage when needed. In viral infections, imaging is critical to exclude entities that may manifest with similar clinical and laboratory findings. Disseminated fungal infections require early detection at imaging because they can be fatal if not promptly treated. Familiarity with the epidemiology, pathogenesis, clinical manifestations, imaging features, and treatment of hepatic infections can aid in radiologic diagnosis and guide appropriate patient care.

Original languageEnglish
Pages (from-to)1001-1023
Number of pages23
JournalRadiographics
Volume36
Issue number4
DOIs
StatePublished - Jul 1 2016

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