Spiral CT findings of inflammatory pseudotumor of the liver

To assess the spiral CT findings of inflammatory pseudotumor of the liver(IPTL), in order to distinguish this tumor from hepatocellular carcinoma, hepatic abscess or other space occupying liver lesions. The spiral CT findings of IPTL were retrospectively evaluated in six patients. All cases were confirmed by ultrasonography-guided gun biopsy. Four patients were men and two were women, and they were aged between 37 and 74 (mean, 49) years. The site, size, and number of IPTL were assessed, and their enhancement patterns were evaluated during the arterial, portal and delayed phases of spiral CT. Five cases involved a solitary mass and in one there were multiple masses with surrounding small nodules. Four cases occurred in the right lobe and two in the left lobe. Four of five surrounding nodules were in the left lobe. During the arterial phase of spiral CT scanning, three layers were separated from four of five cases of solitary mass;they were composed of central and peripheral portions of low attenuation, and an intermediate portion of isoattenuation. Delayed enhancement of the peripheral portion was prominent during the delayed phase. In the case involving multiple masses three layers were not seen during the arterial phase, but during the delayed phase enhancement was noted. The features of three layers, as seen on spiral CT, is considered to be very specific for distinguishing IPTL from other hepatic focal lesions.=20