Axial CT Slices of the Abdomen to Detect Amebic Abscess Liver

Hepatic infections may caused by bacterial (85%), fungal(9%) or parasitic (6%) infections. The most common causative agent are E .colli, Streptococci, Actinomyces,Candida, Entamoeba histolytica and Echinococcus.

CT is today probably the most reproducible way for imaging liver. With advent of newer CT technology strategies of evaluating the liver have been devised.

Spiral CT(SCT) made acquirement of anatomically consecutive axial sections through liver in single breath–hold and to repeat this procedure in several phases after intranet-vascular in section of contrast medium possible.

Location for the lower abdominal region taken from a CT-general begins with the first slice in the xiphoid process illiaca forwarded to the crista. For the pelvic area taken in the first slice starts with crista illiaca and forwarded to the symphysis pubis. For routine abdominal examination is generally 10 mm thick slice. 
On a routine abdominal examination with serial scanning takes ± 1 second to see the process of peristalsis and respiration. (Bontrager, 2001).
Contrast media preparation

Availability of contrast media injectors also contributed to the standardization of this injection to more accurately depict the different vascular phases during distribution of contrast medium enabling both detection and characterization of focal liver lesions.

Contrast media through the mouth and rectum for a CT-Abdomen and pelvis (rectal contrast media used if oral contrast media can not get into the rectum). Oral contrast media through to see or distinguish the organ in the gastrointestinal tract. There are 2 (two) types of contrast to show the opacity of the tractus gastrointestinal barium sulfate suspensions and water-soluble solution (diatrizoate meglumine or diatrizoate sodium) (Bontrager, 2001).
Oral contrast medium administered before the examination. There are 3 (three) levels of media contrast administered orally to patients:

• The night before the examination.
• One hour before the examination.
• In the middle before the examination.

Routine abdominal CT protocols consist of a axial plain survey of liver. Spiral CT scan the abdomen pelvis after oral and intravenous administration of contrast material. Typically, 100 mL(300 mg/mL iodine) of iohexol is injected at arate of 2-3 mL/sec. Beginning 25 second after initiation of the contrast material injection, a30 second breath-hold arterial phase helical CT scan was acquired with section thickness of 5 mm and pich (usually 1.0-1.6) sufficient to cover the entire liver within the breath-hold period.

A breath-hold portal venous phase scan was obtained 60-70 second after initiation of the   injection. Images were reconstructed at 3 mm intervals through the lesions with use of standard soft tissue(windows with, 400 HU;level,40 HU) and liver (windows width, 150 HU;level ,50-80 HU)display settings.

Axial slices of the Abdomen

The axial CT slices of the abdomen with 10 mm of each slice. First with 50 cc bolus injection and drip infusion of 100 cc with intravenous contrast. Preparation of oral contrast with water-soluble solution.
Film processing is to convert the latent image in the form of emulation of the film during exposed  transformed into a shadow form of silver through a chemical process. (Jenkin, D, 1980)
Automatic film processing is the process of processing the film with the film transport system, followed by a working roller with face velocity. In automatic film processing using the solution concentration and high temperature of the manual process so much faster time.

Entamoeba histolytica is endemic worldwide, with as estimated 10% of the worlds population being infected. It is most prevalent in India , Africa, the Far East and central and south America. Amebic liver disease is the most common extras intestinal complication occurs because colonic trophozoites ascend via the portal vein and invade the parenchyma.

See the figure Axial CECT showing a capsulated segment 3 abscess.

Contrast enhanced CT, amebic abscess usually appear as rounded , well defined lesions with attenuation values that indicate the presence of complex fluid(10-20HU). An enhancing wall 3-15 mm in thickness and peripheral zone of edema around the abscess are common and some what characteristic for this lesion. The central abscess cavity may show multiple septa or fluid-debris levels and , rarely , air bubbles or hemorrhage. Extrahepatic extension of amebic abscess is relatively common and involvement the chest wall, pleural cavity, pericardium an adjacent viscera has been reported.