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{{Hepatitis C}}
{{Hepatitis C}}
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==Overview==
CT scan of HCV infection often shows [[hepatomegaly]] in the acute and early chronic HCV phase. It may, however, show normal findings. In contrast, findings on CT scan may be consistent with [[cirrhosis]] and [[portal hypertension]], such as widening of the [[portal tract]], [[ascites]], and [[hepatosplenomegaly]], or hepatic and extrahepatic masses suggestive of localized [[hepatocellular carcinoma]] and [[metastasis]], respectively.


==CT Imaging==
==CT Imaging==
CT scan may be done to:
Computed tomography (CT) scan findings of HCV are non-specific. In the majority of patients with acute HCV infection, CT scan will show normal findings or enlarged liver volume suggestive of [[hepatomegaly]].
* Exclude biliary obstruction.  
 
* Assess for [[hepato cellular carcinoma]].
CT scan may also be helpful in the diagnosis of HCV-induced hepatic complications: 
===CT Scan Findings of Cirrhosis===
====Early Findings<ref name="pmid23986608">{{cite journal| author=Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG| title=MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications. | journal=HPB Surg | year= 2013 | volume= 2013 | issue=  | pages= 129396 | pmid=23986608 | doi=10.1155/2013/129396 | pmc=PMC3748773 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23986608  }} </ref>====
CT scan is insensitive and unspecific in early cirrhosis. Early findings may include:
*[[Hepatomegaly]] or shrunken liver
*Widening of the porta hepatis
*Enlarged interlobar fissure
*Expansion of [[pericholecystic space]]
*[[Portal hypertension]]
*Visible [[left gastric]], [[retrogastric]], [[paraumbilical]] and other venous collaterals
*[[Splenomegaly]]
*[[Ascites]]
*Intra and retroperitoneal edema
*[[Small bowel]] and [[gallbladder]] wall thickening
 
====Late Findings<ref name="pmid23986608">{{cite journal| author=Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG| title=MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications. | journal=HPB Surg | year= 2013 | volume= 2013 | issue=  | pages= 129396 | pmid=23986608 | doi=10.1155/2013/129396 | pmc=PMC3748773 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23986608  }} </ref>====
*Diffuse hepatic [[fatty infiltration]]
*Heterogeneous aspect of the liver
*Hypoattenuation of the liver parenchyma
*[[Regenerative nodule]]s observed in the monitory of patients
*Nodular hepatic appearance
 
===CT Scan Findings of Hepatocellular Carcinoma<ref name="pmid23986608">{{cite journal| author=Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG| title=MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications. | journal=HPB Surg | year= 2013 | volume= 2013 | issue=  | pages= 129396 | pmid=23986608 | doi=10.1155/2013/129396 | pmc=PMC3748773 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23986608  }} </ref>===
The evaluation of hepatocellular carcinoma (HCC) due to viral hepatitis and subsequent cirrhosis requires a triple phase evaluation of the liver.<ref name="pmid23986608">{{cite journal| author=Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG| title=MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications. | journal=HPB Surg | year= 2013 | volume= 2013 | issue=  | pages= 129396 | pmid=23986608 | doi=10.1155/2013/129396 | pmc=PMC3748773 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23986608  }} </ref>
*Mass of variable size
*Homogeneous aspect (small masses) or heterogeneous aspect (large masses)
*Presence of hypodense [[fibrous capsule]]
*Intranodular vascular changes
*Infiltration of adjacent structures
*Mass lesions in distant organs suggestive of distant [[metastasis]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Hepatitis|C]]
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Latest revision as of 22:05, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

CT scan of HCV infection often shows hepatomegaly in the acute and early chronic HCV phase. It may, however, show normal findings. In contrast, findings on CT scan may be consistent with cirrhosis and portal hypertension, such as widening of the portal tract, ascites, and hepatosplenomegaly, or hepatic and extrahepatic masses suggestive of localized hepatocellular carcinoma and metastasis, respectively.

CT Imaging

Computed tomography (CT) scan findings of HCV are non-specific. In the majority of patients with acute HCV infection, CT scan will show normal findings or enlarged liver volume suggestive of hepatomegaly.

CT scan may also be helpful in the diagnosis of HCV-induced hepatic complications:

CT Scan Findings of Cirrhosis

Early Findings[1]

CT scan is insensitive and unspecific in early cirrhosis. Early findings may include:

Late Findings[1]

  • Diffuse hepatic fatty infiltration
  • Heterogeneous aspect of the liver
  • Hypoattenuation of the liver parenchyma
  • Regenerative nodules observed in the monitory of patients
  • Nodular hepatic appearance

CT Scan Findings of Hepatocellular Carcinoma[1]

The evaluation of hepatocellular carcinoma (HCC) due to viral hepatitis and subsequent cirrhosis requires a triple phase evaluation of the liver.[1]

  • Mass of variable size
  • Homogeneous aspect (small masses) or heterogeneous aspect (large masses)
  • Presence of hypodense fibrous capsule
  • Intranodular vascular changes
  • Infiltration of adjacent structures
  • Mass lesions in distant organs suggestive of distant metastasis

References

  1. ↑ 1.0 1.1 1.2 1.3 Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG (2013). "MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications". HPB Surg. 2013: 129396. doi:10.1155/2013/129396. PMC 3748773. PMID 23986608.

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