Alcoholic hepatitis CT: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Alcoholic hepatitis}} | {{Alcoholic hepatitis}} | ||
{{ | {{CMG}}; {{AE}}{{S.M}} | ||
==Overview== | ==Overview== | ||
[[CT scan]] is usually performed among [[patients]] with [[Alcoholic Hepatitis]] to exclude other abnormalities including [[neoplasm]], [[biliary]] [[obstruction]] or [[infiltrative]] [[liver]] [[disease]].[[CT scan]] can predict [[severity]] and [[outcome]] of [[Alcoholic Hepatitis]] by presence of [[splenomegaly]], [[ascites]], [[varices]], [[liver]] length to mid [[clavicular]] line, decreased [[liver]] [[attenuation]], [[liver]] to [[spleen]] [[attenuation]] ratio and increased [[liver]] [[heterogenecity]]. | |||
== CT== | == CT== | ||
* [[CT scan]] is usually performed among [[patients]] with [[Alcoholic Hepatitis]] to exclude other abnormalities including [[neoplasm]], [[biliary]] [[obstruction]] or [[infiltrative]] [[liver]] [[disease]]. | * [[CT scan]] is usually performed among [[patients]] with [[Alcoholic Hepatitis]] to exclude other abnormalities including [[neoplasm]], [[biliary]] [[obstruction]] or [[infiltrative]] [[liver]] [[disease]].<ref name="pmid1992635">{{cite journal| author=Chedid A, Mendenhall CL, Gartside P, French SW, Chen T, Rabin L| title=Prognostic factors in alcoholic liver disease. VA Cooperative Study Group. | journal=Am J Gastroenterol | year= 1991 | volume= 86 | issue= 2 | pages= 210-6 | pmid=1992635 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1992635 }} </ref><ref name="pmid24757653">{{cite journal| author=Suk KT| title=Hepatic venous pressure gradient: clinical use in chronic liver disease. | journal=Clin Mol Hepatol | year= 2014 | volume= 20 | issue= 1 | pages= 6-14 | pmid=24757653 | doi=10.3350/cmh.2014.20.1.6 | pmc=3992331 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24757653 }} </ref> | ||
*[[CT scan]] can predict [[severity]] and [[outcome]] of [[Alcoholic Hepatitis]] by presence of the following findings: | *[[CT scan]] can predict [[severity]] and [[outcome]] of [[Alcoholic Hepatitis]] by presence of the following findings: <ref name="pmid31363954">{{cite journal| author=Bloom PP, Mojtahed A, Bethea ED, Knooihuizen SA, Choi J, Dienstag JL | display-authors=etal| title=Computed Tomography Findings as a Novel Predictor of Alcohol-Associated Hepatitis Outcomes. | journal=Dig Dis Sci | year= 2020 | volume= 65 | issue= 1 | pages= 312-321 | pmid=31363954 | doi=10.1007/s10620-019-05721-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31363954 }} </ref><ref name="pmid24594420">{{cite journal| author=Maruzzelli L, Parr AJ, Miraglia R, Tuzzolino F, Luca A| title=Quantification of hepatic steatosis: a comparison of computed tomography and magnetic resonance indices in candidates for living liver donation. | journal=Acad Radiol | year= 2014 | volume= 21 | issue= 4 | pages= 507-13 | pmid=24594420 | doi=10.1016/j.acra.2014.01.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24594420 }} </ref><ref name="pmid16484355">{{cite journal| author=Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW | display-authors=etal| title=Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. | journal=Radiology | year= 2006 | volume= 239 | issue= 1 | pages= 105-12 | pmid=16484355 | doi=10.1148/radiol.2391050361 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16484355 }} </ref> | ||
** [[Splenomegaly]], defined as [[spleen]] dimension ≥ 13 cm | ** [[Splenomegaly]], defined as [[spleen]] dimension ≥ 13 cm | ||
** [[Ascites]] | ** Degree of [[Ascites]]; mild , moderate or severe | ||
** [[Varices]]; defined as moderate if esophageal varices < 3 mm or paraesophageal varices < 5 mm, severe varices defined as esophageal varices > 3 mm or paraesophageal varices > 5 mm | ** [[Varices]]; defined as moderate if [[esophageal]] [[varices]] < 3 mm or [[paraesophageal]] [[varices]] < 5 mm, severe [[varices]] defined as [[esophageal]] [[varices]] > 3 mm or [[paraesophageal]] [[varices]] > 5 mm <ref name="pmid24723070">{{cite journal| author=Lee JY, Kim TY, Jeong WK, Kim Y, Kim J, Kim KW | display-authors=etal| title=Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis. | journal=Dig Dis Sci | year= 2014 | volume= 59 | issue= 9 | pages= 2333-43 | pmid=24723070 | doi=10.1007/s10620-014-3149-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24723070 }} </ref> | ||
** [[Liver]] length to mid [[clavicular]] line | ** [[Liver]] length to mid [[clavicular]] line | ||
** [[Liver]] [[attenuation]] | ** Decreased [[Liver]] [[attenuation]] around [[portal]] [[system]] | ||
**[[ | ** [[Liver]] to [[spleen]] [[attenuation]] ratio > 10 hounsfield units is suggestive of [[hepatic]] [[steatosis]] <ref name="pmid6934563">{{cite journal| author=Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA| title=Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. | journal=Radiology | year= 1980 | volume= 137 | issue= 3 | pages= 727-9 | pmid=6934563 | doi=10.1148/radiology.137.3.6934563 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6934563 }} </ref> | ||
** Increased [[Liver]] [[heterogenecity]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 03:23, 31 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
CT scan is usually performed among patients with Alcoholic Hepatitis to exclude other abnormalities including neoplasm, biliary obstruction or infiltrative liver disease.CT scan can predict severity and outcome of Alcoholic Hepatitis by presence of splenomegaly, ascites, varices, liver length to mid clavicular line, decreased liver attenuation, liver to spleen attenuation ratio and increased liver heterogenecity.
CT
- CT scan is usually performed among patients with Alcoholic Hepatitis to exclude other abnormalities including neoplasm, biliary obstruction or infiltrative liver disease.[1][2]
- CT scan can predict severity and outcome of Alcoholic Hepatitis by presence of the following findings: [3][4][5]
- Splenomegaly, defined as spleen dimension ≥ 13 cm
- Degree of Ascites; mild , moderate or severe
- Varices; defined as moderate if esophageal varices < 3 mm or paraesophageal varices < 5 mm, severe varices defined as esophageal varices > 3 mm or paraesophageal varices > 5 mm [6]
- Liver length to mid clavicular line
- Decreased Liver attenuation around portal system
- Liver to spleen attenuation ratio > 10 hounsfield units is suggestive of hepatic steatosis [7]
- Increased Liver heterogenecity
References
- ↑ Chedid A, Mendenhall CL, Gartside P, French SW, Chen T, Rabin L (1991). "Prognostic factors in alcoholic liver disease. VA Cooperative Study Group". Am J Gastroenterol. 86 (2): 210–6. PMID 1992635.
- ↑ Suk KT (2014). "Hepatic venous pressure gradient: clinical use in chronic liver disease". Clin Mol Hepatol. 20 (1): 6–14. doi:10.3350/cmh.2014.20.1.6. PMC 3992331. PMID 24757653.
- ↑ Bloom PP, Mojtahed A, Bethea ED, Knooihuizen SA, Choi J, Dienstag JL; et al. (2020). "Computed Tomography Findings as a Novel Predictor of Alcohol-Associated Hepatitis Outcomes". Dig Dis Sci. 65 (1): 312–321. doi:10.1007/s10620-019-05721-4. PMID 31363954.
- ↑ Maruzzelli L, Parr AJ, Miraglia R, Tuzzolino F, Luca A (2014). "Quantification of hepatic steatosis: a comparison of computed tomography and magnetic resonance indices in candidates for living liver donation". Acad Radiol. 21 (4): 507–13. doi:10.1016/j.acra.2014.01.007. PMID 24594420.
- ↑ Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW; et al. (2006). "Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment". Radiology. 239 (1): 105–12. doi:10.1148/radiol.2391050361. PMID 16484355.
- ↑ Lee JY, Kim TY, Jeong WK, Kim Y, Kim J, Kim KW; et al. (2014). "Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis". Dig Dis Sci. 59 (9): 2333–43. doi:10.1007/s10620-014-3149-8. PMID 24723070.
- ↑ Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980). "Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease". Radiology. 137 (3): 727–9. doi:10.1148/radiology.137.3.6934563. PMID 6934563.