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The Journal of Nuclear Medicine Vol. 38 No. 8 1282-1283
© 1997 by Society of Nuclear Medicine
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The Rim Sign in Hepatic Abscess: Case Report and Review of the Literature

Kathleen L. McDonald and Mandana Davani

Department of Radiology, The Mercy Hospital of Pittsburgh, 1400 Locust Street, Pittsburgh, Pennsylvania

Correspondence: For correspondence contact: Mandana Davani, MD; for correspondence or reprints contact: Kathleen L. McDonald, MD, Department of Radiology, The Mercy Hospital of Pittsburgh, 1400 Locust Street, Pittsburgh, PA 15219-5166.

ABSTRACT

We studied a previously healthy patient who presented with a 3-wk history of fever, flulike symptoms and abdominal pain. Methods: Blood cultures were positive for Escherichia coli. A computed tomography (CT) scan revealed a 2-cm low-density focus in the right hepatic lobe. A technetium-99m-mebrofenin scan showed a photopenic area in the right hepatic lobe surrounded by a rim of activity greater than the adjacent parenchyrrlal activity. Results: Gallbladder visualization was normal and the diagnosis of hepatic abscess was made. CT-guided percutaneous drainage of the lesion yielded six cc of pus, the culture of which grew E. coli, Prevotella and Bacteroides fragilis. Drainage and a 6-wk course of intravenous antibiotics were followed by clinical improvement and resolution of the abscess by CT. Conclusion: The rim sign and its possible mechanism of causation in hepatic abscess are discussed in this report, together with a review of the literature.

Key Words: rim sign • hepatobiliary scan • hepatic abscess






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Copyright © 1997 by the Society of Nuclear Medicine.