Perihepatitis with pelvic inflammatory disease (PID) on MDCT: characteristic findings and relevance to PID

Abdom Imaging. 2009 Nov;34(6):737-42. doi: 10.1007/s00261-008-9472-9. Epub 2008 Nov 11.

Abstract

Background: To evaluate the prevalence and image characteristics of perihepatitis, as well as the relationship with some computed tomography (CT) manifestations of pelvic inflammatory disease (PID).

Methods: Between January 2006 and December 2007, 93 consecutive patients examined with three-phase abdominal CT scans and clinically diagnosed and treated for PID were included. Three radiologists retrospectively reviewed CT scans with consensus, and examined the location (12 areas) and thickness (four grades) of enhancement of the hepatic surface. Several CT manifestations of PID were also evaluated and statistical analysis was performed to determine the relationship of these findings.

Results: Out of the 93 patients, 55 (59%) showed enhancement of the hepatic surface. The right anteroinferior hepatic surface was the most common site (89%) and lower hepatic division showed thicker parenchymal enhancement. Oophoritis (P = 0.020) and extension of mesenteric infiltration (P < 0.001) were revealed as statistically significant factors associated with the presence of perihepatitis in PID.

Conclusions: Perihepatits commonly occurs in PID; 59% of PID patients in this study had perihepatitis. The predominant site was the right anteroinferior hepatic surface. Perihepatitis seems not to be associated with various CT findings of PID reflecting disease severity, except oophoritis and upper extension of mesenteric infiltration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chi-Square Distribution
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Hepatitis / complications
  • Hepatitis / diagnostic imaging*
  • Hepatitis / pathology
  • Humans
  • Image Interpretation, Computer-Assisted
  • Iohexol / analogs & derivatives
  • Liver Function Tests
  • Middle Aged
  • Pelvic Inflammatory Disease / complications
  • Pelvic Inflammatory Disease / diagnostic imaging*
  • Pelvic Inflammatory Disease / pathology
  • Retrospective Studies
  • Syndrome
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iohexol
  • iopromide