 Hello, everyone. I'm Dr. Akansha Mimdala, JR3, Department of Radio Diocese, from MGIMS, Pivagram, Bartha. Today, I'm presenting a paper on CT differentiation of pyogenic liver abscesses caused by Klebselia pneumonia versus non-Klebselia pneumonia. Abstract. The objective of my study is CT findings in liver abscesses caused by Klebselia pneumonia compared with those caused by other bacterial pathogens. The most commonly isolated from pyogenic liver abscesses in Asian populations. Previously, the most common organism was E. coli. Now, it is Klebselia pneumonia in many Asian populations and in some western populations. Differences between Klebselia pneumonia and non-Klebselia pneumonia. Higher frequency of bacteria, metastatic infection, is present in Klebselia as compared to non-Klebselia. However, mortality rate is more in case of non-Klebselia. Prognosis is poor in case of Klebselia pneumonia infections, while underlying biliary disease is more in non-Klebselia pneumonia infection. Bread resistance to ampicillin is present in Klebselia pneumonia infections. Early recognition of KLA is important. The clinical presentation and laboratory findings of patients with KLA are similar to those of patients with other pyogenic liver abscesses. Blood or past culture, imaging modalities such as ultrasonography and computer tomography have been used to diagnose liver abscesses. The purpose of our study was to retrospectively compare the clinical and CT teachers of pyogenic liver abscesses caused by Klebselia pneumonia and other bacterial pathogens and to identify differences let me assist in differential diagnosis. Methods and Materials Patients. Retrospective single institution study approved by institutional review board. Consent was routinely obtained from all patients before all CT examinations and interventional procedures such as aspiration of abscess pass. A search of medical record was performed to identify all patients in whom a liver abscess was diagnosed between December 2020 to September 2022. Out of 214 patients, 85 patients were excluded for one of the following reasons. In three patients, no CT had been performed. In seven patients, only a non-enhanced CT study had been performed. In 69 patients, past culture did not reveal a positive finding. In one patient, lesion that had been depicted in imaging studies did not resolve after antibiotic treatment. In two patients, the patient had a suspected amybic or fungal abscess. While in three patients, CT scans were obtained after interventional procedures or surgeons. Out of 129 consecutive patients, clinically proven pyogenic liver abscesses, 60 men and 69 women with a mean age of 67 years. All patients and event at the sumagupi guided needle aspiration for cutaneous abscess drainage or surgical drainage. Two groups, Klebselia pneumonia, monomicrobial pyogenic liver abscesses, KLA group and the non-Klebselia pneumonia monomicrobial or polymicrobial pyogenic liver abscesses that is a non-KLA group. A mono-microbial and polymicrobial liver abscess. Medical data including clinical imaging and laboratory parameters for the 129 patients were reviewed with particular attention to the presence of diabetes mellitus or metastatic infection in other parts of the body. It has meningitis, endothelitis, lung abscess, kidney abscess or fisciitis. CT, average of 0.7 days before the procedures or surgeries. CT examinations were performed using a light speed QXI4 detector rose scan or somatome sensation 16 multi-detector rose scanner. The CT techniques varied because of the retrospective nature of this test. Most patients underwent dynamic CT and the remaining 11 patients underwent single phase CT. Generally unenhanced and dual phase contrast enhanced helical scans were obtained. After that unenhanced CT scan was obtained 150 ml of iotomyte. Ultravis 370 was administered at a flow rate of 3 to 4 ml per second using a mechanical injector. The scan delay time was determined using the Polish tracking technique. Late arterial phase scanning was automatically initiated at 10 seconds after the contrast enhancement of the iota reached the preferred point that is 100-inch. Portal venous phase scanning was obtained 20 seconds after the completion of the late arterial phase. These are the CT scan images showing hepatic abscesses. CT interpretation, two experienced abdominal radiologists retrospectively reviewed the CT images and developed a consensus opinion. Both radiologists were aware that the patients had hepatic abscesses but they were blinded to the results of the microbiological and clinical findings. During the analysis of the CT features, cases from the TLA and non-TLA group were randomly interrupted. CT images of abscesses were analysed in terms of the number, location, size and configuration of the abscesses. The thickness of the abscess wall, autonofrim enhancement, septal enhancement, double target sign, internal necrotic debris, internal gas bubbles. Additionally, the radiologists recorded the presence of underlying biliary disease including stones in the piled-up, air in the biliary tray, piled-up obstruction, polycystitis and any previous hepatic biliary operation. The abscess wall, one layer or two layers with varying degrees of enhancement were seen with central necrotic areas and surrounding hepatic parenchar. The maximum thickness of wall was classified as thick equal to or greater than 2 mm or thin which is less than 2 mm. The pattern of the enhancement that is increased was defined as majority of the margin having higher attenuation than the surrounding liver or no enhancement. The presence of septal enhancement were septal attenuation in the abscess cavity higher than that of the surrounding liver. Double target sign consisted of a hypo-concentral abscess cavity surrounded by an inner hypodense ring and an outer hypodense zone on dynamic contrast enhanced CT. Necrotic debris, solid component with enhancement similar to or less than that of the adjacent liver, larger than 1 cm in diameter in the hypodense central necrotic area. Statistical analysis, a car square test used to differentiate in clinical and CT features between patients in the PLA and non-PLA groups. Differences in age and in the size and number of abscess between groups were analyzed using students' CT test. A multivariate step logistic regression analysis used to test the univariate model demonstrated the best predictors of the PLA versus non-PLA groups. Using these data, the sensitivity, specificity and accuracy of the criteria for differentiating PLA from non-PLA were evaluated. A p-value of less than 0.05 was deemed to indicate a statistically significant difference in all analysis. All statistical analysis were performed using the SPSS software package. Results, out of 1.29 patients, 59 mono-microbial infections were caused by Klebsiella pneumonia KLA group. 70 patients, non- Klebsiella pneumonia mono-microbial or poly-microbial infection that is non-PLA group were diagnosed by blood and or abscess aspirate culture. No significant difference in age and gender production between the two groups. Univariate analysis shows significant differences between the PLA and non-PLA groups. The KLA group with 10 world abscesses, no remunhancement and necrotic degrees. Non-KLA group had 3 world abscesses, increased enhancement and target size. Underline biliary disease in non-KLA group was more than in the KLA group. Difference was statistically significant. Metastatic infection on permanently developing 12-49 patients in the KLA group of whom 10 were diabetics. One of the 70 patients in the non-KLA group. This was also significantly different. Of the 12 patients with metastatic infection in the KLA group, 4 developed endophthalmitis, 4 developed lung abscesses, 2 renal abscesses, 1 brain abscess and 1 patient developed endophthalmitis, the lung and brain abscesses. Multi-variate stepwise characteristic regression analysis showed that the thin wall abscess, internal necrotic degrees, absence of underlying biliary disease and presence of metastatic infection were the most significant predictors of KLA. Conclusion. Despite the study's limitations, a Kenwall abscess, necrotic degrees in the abscess cavity, presence of metastatic infection, absence of underlying biliary disease were most significant findings for discriminating KLA from non-KLA in patients with pyogenic liver abscesses in an Asian population. The combined presence of these findings was highly suggestive of KLA and would therefore be helpful in differential diagnosis. Thanks.