Solid organizing hepatic abscesses mimic hepatic tumor: Multiphasic computed tomography and magnetic resonance imaging findings with histopathologic correlation

Objective: To describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings of solid organizing hepatic abscesses and correlate them with the pathologic findings. Methods: Ten patients with 10 pathologically proven solid organizing hepatic abscesses who underwent 3-phase CT (n = 10) or MRI (n = 7) were enrolled in this study. Images were retrospectively analyzed by consensus of 2 radiologists for attenuation (signal intensity), shape, and margin of the lesions as well as for their enhancement patterns. Their imaging findings were correlated with their pathologic findings. Results: The main imaging finding on CT or MRI was the well-defined target appearance of a central enhancing area with a low-attenuation (signal intensity) rim on arterial and portal phases. On the delayed phase, most of lesions showed slightly low attenuation (signal intensity) with an enhancing rim, and 1 showed diffuse enhancement. Pathologically, the central areas and peripheral rims corresponded to granulation tissue and fibrosis, respectively. Nine lesions demonstrated a tiny necrotic cystic portion in the center. Conclusion: The target appearance of solid organizing hepatic abscesses on CT and MRI can be helpful in differentiating them from other focal liver lesions. These imaging findings are well correlated with the pathologic findings.