Kim et al classified imaging changes associated with perihepatitis secondary to pelvic inflammatory disease (PID), constituting Fitz-Hugh-Curtis Syndrome (FHCS). The authors are from Hanyang University in Korea.
Sites examined by CT scan:
(1) hepatic surface
(2) mesentery
(3) retroperitoneum
The hepatic surface was divided into 12 zones:
(1) there were 3 divisions: upper, middle and lower
(2) each division was divided into 4 segments: right anterior, right posterior, left anterior and left posterior
The depth of enhancement seen on CT scan over the hepatic surface on arterial phase was graded as follows:
|
Depth of Enhancement Over the Hepatic Surface |
Grade |
|
no enhancement |
0 |
|
linear enhancement of the capsule |
1 |
|
enhancement < 0.5 cm below the capsular surface |
2 |
|
0.5 to 1.0 cm below the capsular surface |
3 |
|
> 1 cm below the capsular surface |
4 |
Infiltration of the mesentery and retroperitoneum is also graded.
|
Mesenteric Infiltration |
Grade |
|
none |
0 |
|
confined to below the anterior superior iliac spine (ASIS) |
1 |
|
extends above the ASIS but below the umbilicus |
2 |
|
extends above the umbilicus |
3 |
|
Retroperitoneal Infiltration |
Grade |
|
none |
0 |
|
confined to below the anterior superior iliac spine (ASIS) |
1 |
|
extends above the ASIS but below the umbilicus |
2 |
|
extends above the umbilicus |
3 |
Features associated with perihepatitis in a patient wth PID:
(1) oophoritis
(2) grade of mesenteric infiltration
Specialty: Infectious Diseases
