TY - JOUR
T1 - Pyogenic liver abscess treated by percutaneous catheter drainage
T2 - MDCT measurement for treatment outcome
AU - Liao, Wen I.
AU - Tsai, Shih Hung
AU - Yu, Chih Yung
AU - Huang, Guo Shu
AU - Lin, Yen Yue
AU - Hsu, Ching Wang
AU - Hsu, Hsian He
AU - Chang, Wei Chou
PY - 2012/4
Y1 - 2012/4
N2 - Objective: To analyze multidetector computed tomographic (MDCT) parameters in patients with pyogenic liver abscess (PLA), and to identify which parameters can be predicted percutaneous catheter drainage (PCD) treatment outcome. Materials and methods: Clinical, laboratory and MDCT findings of 175 patients with PLA who had undergone PCD were retrospectively reviewed. All abscesses shown on MDCT were evaluated for size, margin, attenuation values, location, number of large (>3 cm) abscesses, presence of a cystic component, presence of gas, and the shortest length to the liver capsule. Univariate and multivariate analyses of the MDCT parameters that affect PCD treatment outcome was performed. For continuous data of MDCT parameters (abscess size and the shortest length), we used receiver-operating-characteristic (ROC) curve to determine the optimal cut-off values. Results: PCD was failed in 32 patients and the overall failure rate was 18.28%. Multivariate analysis revealed that PCD failure was predicted by the presence of gas (odds ratio [OR], 42.67), a large abscess (OR 1.21), low minimal attenuation values (OR 1.02), wide range of attenuation values (OR 1.01), a shorter length to the liver capsule (OR 0.09) and lack of a cystic component (OR 0.09) of the PLA. ROC curve showed that the shortest length less than 0.25 cm and an abscess size greater than 7.3 cm were the optimal cut-off values predicting PCD treatment failure. Conclusion: Among these MDCT parameters, gas formation within PLA was the most important predictor for PCD failure. Surgical intervention might be considered early in high-risk patients of PCD failure.
AB - Objective: To analyze multidetector computed tomographic (MDCT) parameters in patients with pyogenic liver abscess (PLA), and to identify which parameters can be predicted percutaneous catheter drainage (PCD) treatment outcome. Materials and methods: Clinical, laboratory and MDCT findings of 175 patients with PLA who had undergone PCD were retrospectively reviewed. All abscesses shown on MDCT were evaluated for size, margin, attenuation values, location, number of large (>3 cm) abscesses, presence of a cystic component, presence of gas, and the shortest length to the liver capsule. Univariate and multivariate analyses of the MDCT parameters that affect PCD treatment outcome was performed. For continuous data of MDCT parameters (abscess size and the shortest length), we used receiver-operating-characteristic (ROC) curve to determine the optimal cut-off values. Results: PCD was failed in 32 patients and the overall failure rate was 18.28%. Multivariate analysis revealed that PCD failure was predicted by the presence of gas (odds ratio [OR], 42.67), a large abscess (OR 1.21), low minimal attenuation values (OR 1.02), wide range of attenuation values (OR 1.01), a shorter length to the liver capsule (OR 0.09) and lack of a cystic component (OR 0.09) of the PLA. ROC curve showed that the shortest length less than 0.25 cm and an abscess size greater than 7.3 cm were the optimal cut-off values predicting PCD treatment failure. Conclusion: Among these MDCT parameters, gas formation within PLA was the most important predictor for PCD failure. Surgical intervention might be considered early in high-risk patients of PCD failure.
KW - CT attenuation
KW - Gas
KW - Multidetector-row computed tomography
KW - Percutaneous catheter drainage
KW - Pyogenic liver abscess
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U2 - 10.1016/j.ejrad.2011.01.036
DO - 10.1016/j.ejrad.2011.01.036
M3 - Article
C2 - 21330079
AN - SCOPUS:84858275993
SN - 0720-048X
VL - 81
SP - 609
EP - 615
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 4
ER -