Abstract：
To investigate the clinical and CT features of invasive and non-invasive Klebsiella pneumoniae liver abscesses (KPLA).
Fifty-one patients with KPLA diagnosis including 26 invasive and 25 non-invasive KPLA cases were analysed retrospectively. All patients underwent routine abdominal unenhanced and three-phase enhanced CT examinations. The CT images were assessed by two experienced radiologists by examining location, number, size, septa, texture, gas in the pus cavity, portal phlebitis, thrombophlebitis, and abnormal perfusion during the arterial phase. Statistical differences for continuous characteristics were analysed with independent samples t-test or Wilcoxon\'s test, while the chi-square test or Fisher\'s exact test was used for categorical variables. A logistic regression analysis was performed to determine the independent related factors of invasive KPLA and receiver operating characteristic (ROC) curves were used for assessment.
Age and type 2 diabetes were significantly different between the patients with invasive and non-invasive KPLA. In addition, patients with invasive KPLA had lower levels of platelet and total protein (p<0.05) and higher total bilirubin compared to patients with non-invasive KPLA. Throughout the regression analysis, total bilirubin, platelets, and total protein demonstrated an area under the ROC curves of 0.717, 0.745, and 0.728, respectively.
Invasive KPLA occurs predominantly in younger patients with type 2 diabetes. Laboratory tests revealed low platelet and total protein levels and high total bilirubin levels. If the patient with KPLA exhibits hepatic venous thrombophlebitis with no abnormal enhancement around the abscess in the arterial phase of enhanced CT, it indicates that the abscess has invaded.
Fifty-one patients with KPLA diagnosis including 26 invasive and 25 non-invasive KPLA cases were analysed retrospectively. All patients underwent routine abdominal unenhanced and three-phase enhanced CT examinations. The CT images were assessed by two experienced radiologists by examining location, number, size, septa, texture, gas in the pus cavity, portal phlebitis, thrombophlebitis, and abnormal perfusion during the arterial phase. Statistical differences for continuous characteristics were analysed with independent samples t-test or Wilcoxon\'s test, while the chi-square test or Fisher\'s exact test was used for categorical variables. A logistic regression analysis was performed to determine the independent related factors of invasive KPLA and receiver operating characteristic (ROC) curves were used for assessment.
Age and type 2 diabetes were significantly different between the patients with invasive and non-invasive KPLA. In addition, patients with invasive KPLA had lower levels of platelet and total protein (p<0.05) and higher total bilirubin compared to patients with non-invasive KPLA. Throughout the regression analysis, total bilirubin, platelets, and total protein demonstrated an area under the ROC curves of 0.717, 0.745, and 0.728, respectively.
Invasive KPLA occurs predominantly in younger patients with type 2 diabetes. Laboratory tests revealed low platelet and total protein levels and high total bilirubin levels. If the patient with KPLA exhibits hepatic venous thrombophlebitis with no abnormal enhancement around the abscess in the arterial phase of enhanced CT, it indicates that the abscess has invaded.
摘要：
目的：探讨侵袭性与非侵袭性肺炎克雷伯菌肝脓肿(KPLA)的临床及CT表现。
方法：回顾性分析51例诊断为KPLA的患者，包括26例侵入性和25例非侵入性KPLA。所有患者均行常规腹部未增强和三期增强CT检查。CT图像由两名经验丰富的放射科医生通过检查位置进行评估，number,尺寸,隔片,纹理,脓腔中的气体，门脉静脉炎,血栓性静脉炎,动脉期灌注异常。用独立样本t检验或Wilcoxon检验分析连续特征的统计学差异。而分类变量使用卡方检验或Fisher精确检验。进行logistic回归分析以确定侵入性KPLA的独立相关因素，并使用受试者工作特征（ROC）曲线进行评估。
结果：有侵袭性和无侵袭性KPLA患者的年龄和2型糖尿病存在显著差异。此外,与非侵入性KPLA患者相比,侵入性KPLA患者的血小板和总蛋白水平较低(p<0.05),总胆红素水平较高.在整个回归分析中，总胆红素,血小板,和总蛋白的ROC曲线下面积分别为0.717、0.745和0.728。
结论：侵袭性KPLA主要发生在年轻的2型糖尿病患者中。实验室检查显示血小板和总蛋白水平低，总胆红素水平高。如果KPLA患者在CT增强动脉期表现为肝静脉血栓性静脉炎，脓肿周围无异常强化，这表明脓肿已经侵入。
方法：回顾性分析51例诊断为KPLA的患者，包括26例侵入性和25例非侵入性KPLA。所有患者均行常规腹部未增强和三期增强CT检查。CT图像由两名经验丰富的放射科医生通过检查位置进行评估，number,尺寸,隔片,纹理,脓腔中的气体，门脉静脉炎,血栓性静脉炎,动脉期灌注异常。用独立样本t检验或Wilcoxon检验分析连续特征的统计学差异。而分类变量使用卡方检验或Fisher精确检验。进行logistic回归分析以确定侵入性KPLA的独立相关因素，并使用受试者工作特征（ROC）曲线进行评估。
结果：有侵袭性和无侵袭性KPLA患者的年龄和2型糖尿病存在显著差异。此外,与非侵入性KPLA患者相比,侵入性KPLA患者的血小板和总蛋白水平较低(p<0.05),总胆红素水平较高.在整个回归分析中，总胆红素,血小板,和总蛋白的ROC曲线下面积分别为0.717、0.745和0.728。
结论：侵袭性KPLA主要发生在年轻的2型糖尿病患者中。实验室检查显示血小板和总蛋白水平低，总胆红素水平高。如果KPLA患者在CT增强动脉期表现为肝静脉血栓性静脉炎，脓肿周围无异常强化，这表明脓肿已经侵入。
