CT and MRI findings in focal eosinophilic infiltration of the liver

• Published in: Abdominal imaging Vol. 42; no. 12; pp. 2874 - 2881
• Main Authors: Guo, Bao-liang, Hu, Qiu-gen, Ouyang, Fu-sheng, Zhang, Bin, Dong, Yu-hao, Luo, Xiao-ning, Lian, Zhou-yang, Zhang, Shui-xing
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2017; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Attenuation; Blood diseases; Child; Child, Preschool; Computed tomography; Contrast Media; Correlation analysis; Eosinophilia - diagnostic imaging; Eosinophilia - pathology; Eosinophils; Female; Gastroenterology; Hepatology; Humans; Image contrast; Imaging; Infant; Infiltration; Iohexol - analogs & derivatives; Lesions; Leukocytes (eosinophilic); Liver; Liver Diseases - diagnostic imaging; Liver Diseases - pathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Meglumine - analogs & derivatives; Middle Aged; NMR; Nuclear magnetic resonance; Organometallic Compounds; Parenchyma; Peripheral blood; Portal vein; Radiology; Retrospective Studies; Tomography, X-Ray Computed - methods; Veins & arteries; Hepatic infiltration; Computed tomography; Magnetic resonance imaging; Eosinophilia
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-017-1230-4

Objectives To investigate the findings of computed tomography (CT) and magnetic resonance imaging (MRI) of focal eosinophilic infiltration (FEI) of the liver. Methods A retrospective study including 29 patients with confirmed FEI of the liver was performed. We evaluated the lesions’ number, distribution, size, shape, margin, attenuation or signal intensity characteristics, the enhancement pattern, and some special features. Spearman correlation analysis was used to analyze the correlation between the number of lesions and the eosinophil counts in peripheral blood. Results In all, 108 lesions were detected in 29 cases, including two cases with single lesion and the remaining 27 cases with multiple lesions. The mean size of all lesions was 34 mm (range, from 3 to 61 mm). 95 (88%) lesions were located in subcapsular parenchyma or surrounding the portal vein. Most (66%) subcapsular lesions were wedge shaped and all lesions surrounding portal vein were round shaped. However, the hepatic parenchymal lesions were irregular or round shaped. All lesions showed ill-defined margins. On pre-contrast CT images, the lesions showed slightly low attenuation or iso-attenuating. On T1-weighted and T2-weighted images, the lesions were slightly iso-/hypointense and hyperintense, respectively. A total of 23 (79.3%) cases were gradually enhanced. Branches of portal vein went through the lesions in all cases; 12 had ‘stripe sign’ and 16 had ‘halo ring sign.’ Spearman analysis indicated a significant correlation between the number of lesions and the increased eosinophils in peripheral blood ( r  = 0.627, p  = 0.0003). Conclusions Special CT and MRI features and increased eosinophils may strongly suggest the diagnosis of FEI of the liver.