{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:01:21Z","timestamp":1777500081290,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>CT scans of patients with febrile illness occasionally show hepatobiliary changes, although infection does not originate in the hepatobiliary system. These findings may cause radiologists and clinicians to misrecognize hepatobiliary diseases and initiate an inappropriate treatment. Thus, it is important to recognize hepatobiliary CT findings in cases of extrahepatobiliary infectious disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate extrarenal CT manifestations in patients with acute pyelonephritis and to determine the correlation between these extrarenal CT findings and septic liver based on laboratory parameters of sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This study included 157 retrospectively identified patients with confirmed acute pyelonephritis based on CT imaging and urine test, and who had also undergone multi-phase dynamic contrast-enhanced CT scan. Two radiologists reviewed CT findings including early inhomogeneous enhancement of the liver, periportal low density and gallbladder edema, which were correlated with laboratory data including liver function enzymes, albumin, C-reactive protein, white blood cell count, and results of a blood culture by using the Fisher's exact test and Mann-Whitney U test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-six patients (29.3%) showed early inhomogeneous enhancement of the liver, which was associated with increased C-reactive protein ( P &lt; 0.001), a positive blood culture ( P &lt; 0.005), and decreased albumin level ( P &lt; 0.002). The periportal low density and gallbladder wall edema were noted in 15 patients (9.6%) and six patients (3.8%), respectively. These two CT findings were significantly associated with only decreased albumin level ( P &lt; 0.001 and P &lt; 0.040).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early inhomogeneous enhancement of the liver in patients with acute pyelonephritis was significantly associated with increased CRP level, a positive blood culture and decreased albumin level, reflecting sepsis and sepsis-associated liver dysfunction, requiring rapid and appropriate intensive treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0284185113484645","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T00:33:27Z","timestamp":1368146007000},"page":"975-980","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Septic liver: clinical relevance of early inhomogeneous enhancement of the liver in patients with acute pyelonephritis"],"prefix":"10.1177","volume":"54","author":[{"given":"Ga Jin","family":"Han","sequence":"first","affiliation":[{"name":"Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nam Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Un","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Heon","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Sung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong Jae","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"bibr1-0284185113484645","first-page":"335","volume":"29","author":"Unger LS","year":"1989","journal-title":"Circ 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