Periportal halo: A CT sign of liver disease

Lawson, Thomas L.; Thorsen, M K; Erickson, S J; Perret, R S; Quiroz, Francisco; Foley, W D

doi:10.1007/bf00201700

Cited by 54 publications

(23 citation statements)

References 8 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Until recently, there was only sporadic reports on cases of patients with acute pyelonephritis and gallbladder wall thickening or perivascular fluid (13) and periportal edema (14,15) . Periportal edema had already been described for other conditions such as cirrhosis, hepatitis, liver tumors, biliary tract obstruction, liver and bone marrow transplant, heart failure, abdominal trauma in the pediatric population (14,(23)(24)(25) , and even in acute pyelonephritis (7,15) . In the present study this was a relatively frequent finding, present in one-third of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Renal and perirenal tomographic signs found in cases of acute pyelonephritis have been already described in the literature (5,(8)(9)(10) . Few case reports have illustrated the finding of associated extrarenal alterations such as pleural effusion (11,12) , gallbladder wall thickening, perivesicular fluid (13) and periportal edema (14,15) . Until November/ 2006 there was no study in the literature describing a larger series of patients presenting with such extrarenal findings (7) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Freqüência dos sinais de pielonefrite aguda em pacientes submetidos a tomografia computadorizada

et al. 2007

View full text Add to dashboard Cite

OBJECTIVE: The present study was aimed at establishing the frequency of renal/perirenal and extrarenal computed tomography findings in patients with acute pyelonephritis, and evaluating the interobserver agreement. MATERIALS AND METHODS: Retrospective study based on the analysis of computed tomography images of 47 patients with clinical and laboratory findings of acute pyelonephritis. Two independent observers evaluated the main renal/perirenal and extrarenal alterations. The frequency of tomographic findings and interobserver agreement were analyzed by the kappa (κ κ κ κ κ) test. RESULTS: The frequency of tomographic findings for the several parameters was the following: striated nephrogram, 100%; renal enlargement, 65%; perirenal fat heterogeneity, 62.5%; renal calculi, 16.6%; abscesses, 21%; pleural effusion, 36%; thickened gallbladder wall, 32.5%; periportal edema, 32.5%. The κ κ κ κ κ test for interobserver agreement demonstrated reproducibility ranging between moderate (κ κ κ κ κ = 0.511 for renal enlargement) to almost perfect (κ κ κ κ κ = 0.87 for striated nephrogram) for all of the parameters analyzed, except for perirenal fat heterogeneity (κ κ κ κ κ = 0.268).CONCLUSION: The frequency of findings of acute pyelonephritis on computed tomography is high. Overall, striated nephrogram was the most frequent finding. Peri-and extra-renal alterations were found in about 2/3 of the cases. Computed tomography demonstrated a good interobserver agreement. Keywords: Acute pyelonephritis; Kidney; Computed tomography; Reproducibility.Freqüência dos sinais de pielonefrite aguda em pacientes submetidos a tomografia computadorizada. OBJETIVO: Estimar a freqüência das alterações tomográficas renais e extra-renais em pacientes com pielonefrite aguda e avaliar o grau de concordância interobservador. MATERIAIS E MÉTODOS: Realizamos trabalho retrospectivo a partir da análise dos exames de tomografia computadorizada de 47 pacientes com diagnóstico clínico e laboratorial de pielonefrite aguda. Dois examinadores independentes avaliaram as principais alterações renais, perirrenais e extra-renais. Foi medida a freqüência dos achados tomográficos e a concordância interobservador por meio do teste kappa (κ κ κ κ κ). RESULTADOS: A freqüência dos achados tomográficos para os diversos parâmetros estudados foi: nefrograma heterogêneo, 100%; nefromegalia, 65%; heterogeneidade da gordura, 62,5%; nefrolitíase, 16,6%; abscessos, 21%; derrame pleural, 36%; espessamento da vesícula biliar, 32,5%; edema periportal, 32,5%. O teste κ κ κ κ κ para a concordância interobservador demonstrou reprodutibilidade variando entre moderada (κ κ κ κ κ = 0,511 para nefromegalia) e quase perfeita (κ κ κ κ κ = 0,87 para nefrograma heterogêneo) para todos os parâmetros estudados, exceto para a heterogeneidade da gordura perirrenal (κ κ κ κ κ = 0,268). CONCLUSÃO: A freqüência dos diversos achados tomográficos de pielonefrite aguda é elevada, sendo o nefrograma heterogêneo o sinal mais comum. Alterações perinefréticas e extra-renais são observadas em até dois te...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Freqüência dos sinais de pielonefrite aguda em pacientes submetidos a tomografia computadorizada

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Although more than 80% of the hepatic lymph is drained by collecting vessels along the portal vein and bile duct, intrahepatic lymphatic vessels are normally not visualized on CT images. 21,22 However, extrinsic obstruction of the collecting vessels by enlarged nodes of the liver hilum can cause visualization of intrahepatic dilated lymphatic vessels with surrounding lymphedema, 21,22 resulting in periportal low attenuation appearance. Obstruction of those collecting lymphatic vessels by enlarged lymph nodes of the liver hilum can also induce lymphatic edema of the gallbladder wall.…”

Section: Figurementioning

confidence: 98%

F-18 FDG PET/CT Findings in A Case of T-Cell Lymphoma-Associated Hemophagocytic Syndrome With Liver Involvement

Suga¹,

Kawakami²,

Hiyama³

et al. 2010

Clinical Nuclear Medicine

View full text Add to dashboard Cite

This is a report of fluoro-deoxy-glucose positron emission tomography/computed tomography (F-18-FDG PET/CT) findings in a case of T-cell lymphoma-associated hemophagocytic syndrome, with "periportal low attenuation" and edematous gall-bladder wall thickening. FDG PET/CT showed diffuse intense FDG uptake in the enlarged liver and spleen, with systemic FDG-avid lymphadenopathy including the hepatic hilar nodes. Fused plain CT and subsequent contrast-enhanced CT showed no hepatic parenchymal architectural abnormality but periportal low attenuation and edematous gallbladder wall thickening without FDG uptake. The second FDG PET/CT at 6 months after chemoimmunotherapy showed disappearance of the systemic abnormal FDG uptake including the enlarged hepatic hilar nodes and periportal/gall bladder abnormalities, with improvement of hepatosplenomegaly and laboratory data. This case suggests that FDG PET/CT is useful for detecting hepatic involvement of lymphoma and secondary-activated histiocytes causing a hemophagocytic syndrome, and that periportal low attenuation and an edematous gallbladder wall can be an indirect sign of lymphatic obstruction caused by FDG-avid hepatic hilar lymphadenopathy.

show abstract

“…1,12,13 Lymphoma as a part of the spectrum of post-transplant lymphoproliferative disorders (PTLD) seen in the transplant recipients are usually extranodal, the liver being the commonest solid visceral organ to be involved. Three imaging patterns in PTLD of the liver have been described-poorly enhancing circumscribed masses, diffusely infiltrating pattern and an uncommon periportal infiltrating lesion.…”

Section: 10mentioning

confidence: 99%