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Type:
Educational Exhibit
Keywords:
Ultrasound, CT, MR, Spleen, Liver, Abdomen, Treatment effects, Diagnostic procedure, Haematologic diseases, Infection
Authors:
L. Colleter, S. Sillou, A. Lefevre , S. Poiree, J.-M. Correas, O. Hélénon; Paris/FR
DOI:
10.1594/ecr2015/C-0708
Findings and procedure details
Ultrasound (figure 3) :
Easy access particularly if aplasia in intensive care
Hepatomegaly
4 differents patterns :
- aspecific abcess
- bull's eye
- wheel within wheel
- wagon wheel
In chronic lesions,
calcifications may appear
CT-scan (figure 4) :
Sensibility > Ultrasound
3 differents patterns :
- hypodense micronodular lesion with peripheral enhancement
- hypodense without contrast,
non visible at portal phase
- double target
MRI :
Sensibility > CT-scan
3 phases are described :
- acute (figure 6) : round lesion,
size < 1 cm,
hyposignal T1 and hypersignal T2,
hypersignal diffusion,
peripheral enhancement
- sub-acute (figure 7) : round lesion,
size < 1 cm,
dark ring sign (figure 8) (peripheral hyposignal T1 and T2) and central hypersignal T1 and diffusion
- chronic (figure 9) : quadrangular lesions,
size 1 to 3 cm,
global hyposignal T1,
T2 and diffusion.
Complete regression is possible
All 3 phases are correlated with pathology (figure 10)
Associated lesions :
- spleen and kidneys (figure 11-12) : abcess findings (hypersignal T2 - peripheral enhancement - hypersignal diffusion)
- lungs (figure 13) : well defined nodular lesions +/- halo sign - excavation
Follow-up :
Size criteria is irrelevant
MRI allows to monitor treatment efficiency and avoid costly and iatrogenic treatments
Schedule (non consensual) : 3 months - 6 months - 1 year