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

作者：Ronot Maxime^*; Kerbaol Anne; Rautou Pierre Emmanuel; Brancatelli Giuseppe; Bedossa Pierre; Cazals Hatem Dominique; Valla Dominique Charles; Vilgrain Valerie

来源：European Radiology, 2016, 26(9): 3094-3101.

DOI：10.1007/s00330-015-4124-2

• Sinusoidal dilatation
• Computed tomography
• Magnetic resonance imaging
• Mosaic enhancement pattern
• Inflammation and infection

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.
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.
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/mu L (range 11,500-18,000 cells/mu L) 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.
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.
aEuro cent Acute extrahepatic infectious/inflammatory diseases are a cause of transient MP.
aEuro cent In most patients, MP was seen during both arterial and portal venous phase.
aEuro cent In all patients, the mosaic enhancement pattern was diffuse, but more conspicuous in subcapsular areas.
aEuro cent MP was no longer seen after resolution of the acute disease.
aEuro cent No liver biopsy should be performed.

• 出版日期2016-9