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{{Cirrhosis}}
{{Cirrhosis}}
{{CMG}}; {{AE}} {{Cherry}}


{{CMG}} ; {{AE}} {{ADI}}
==Overview==
==Overview==
Although CT scans are not routinely used in evaluation and diagnosis of cirrhosis, it can show the presence of lobar atrophic and hypertrophic changes in the [[liver]], as well as ascites and varices in  advanced disease. CT can also visualize the presence of [[tumors]] and blocked bile ducts, as well as evaluate the size of the liver.
Although CT scans are not routinely used in evaluation and diagnosis of [[cirrhosis]], it may show the presence of [[Hepatic lobule|lobar]] [[Atrophy|atrophic]] and [[Hypertrophy (medical)|hypertrophic]] changes in the [[liver]], [[ascites]] and [[varices]]. CT scans also visualize the presence of [[tumors]], blocked [[Bile duct|bile ducts]] and help evaluate the size of the [[liver]].


== CT ==
==CT==
* [[Computed tomography]] is not routinely used in the [[diagnosis]] and evaluation of [[cirrhosis]].
* [[Computed tomography|Computed tomography (CT) scanning]] complements [[ultrasound]] imaging.
* CT scan is poor at detecting morphologic changes associated with early [[cirrhosis]], but may accurately demonstrate [[Nodule (medicine)|nodularity]] and [[Hepatic lobule|lobar]] atrophic and hypertrophic changes, [[ascites]] and [[varices]] in advanced disease.
* CT findings may suggest the presence of [[cirrhosis]], but is not diagnostic.
* CT portal phase imaging may be used in the assesment of patency of the [[portal vein]].<ref name="urlCirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician">{{cite web |url=http://www.aafp.org/afp/2006/0901/p756.html#afp20060901p756-b20 |title=Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician |format= |work= |accessdate=2012-09-07}}</ref>
* [[Computed tomography|CT]] may be indicative of underlying [[etiology]] due to its classical appearances in some diseases:
**[[Budd-Chiari syndrome]]: hypertrophied [[Caudate lobe of liver|caudate lobe]]
**[[Hemochromatosis|Haemochromatosis]]: excess iron deposition leads to a dramatic increase in [[Liver|hepatic]] density
 
* CT scan in patients with cirrhosis may be used to detect:
** [[Liver|Hepatic]] [[Nodule (medicine)|nodularity]] 
** [[Atrophy]] of the right [[Lobe (anatomy)|lobe]]
** [[Hypertrophy (medical)|Hypertrophy]] of the [[Caudate lobe of liver|caudate]] or left lobes
** [[Ascites]] 
** [[Varices]]
** [[Liver]] size
** Blocked [[bile ducts]]
** Blood flow through the [[liver]]
** [[Tumor|Tumors]]
* Side effects of CT scans:
** Exposure to contrast and [[Radiation (medicine)|radiation]]


[[Computed tomography]] is not routinely used in the diagnosis and evaluation of cirrhosis. It is poor at detecting morphologic changes associated with early cirrhosis, but it can accurately demonstrate nodularity and lobar atrophic and hypertrophic changes, as well as ascites and varices in advanced disease. It provides similar information to ultrasonography, but at the expense of radiation and contrast exposure. CT findings may suggest the presence of cirrhosis, but they are not diagnostic.
CT portal phase imaging can be used to assess portal vein patency, although flow volume and direction cannot be determined accurately.<ref name="urlCirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician">{{cite web |url=http://www.aafp.org/afp/2006/0901/p756.html#afp20060901p756-b20 |title=Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician |format= |work= |accessdate=2012-09-07}}</ref> Computed tomography scan of the abdomen (including the liver, gallbladder, and spleen) can check for tumors and blocked bile ducts and can be used to evaluate liver size and blood flow through the liver.
===CT Images===
===CT Images===
* CT of a [[Cirrhosis|cirrhotic]] patient shows a [[liver]] with a shrunken, [[Nodule (medicine)|nodular]] appearance.
[[File:Output qzgZxt.gif|500px|center|thumb|Liver Cirrhosis <br> Source: Wikimedia commons <ref name="urlFile:Morbus-Osler-CT-Leber-ax-012.jpg - Wikimedia Commons">{{cite web |url=https://commons.wikimedia.org/wiki/File:Morbus-Osler-CT-Leber-ax-012.jpg |title=File:Morbus-Osler-CT-Leber-ax-012.jpg - Wikimedia Commons |format= |work= |accessdate=}}</ref>]]
* Abdominal [[CT scan]] may be helpful in the diagnosis of portal hypertension. Findings on [[CT scan]] suggestive of portal hypertension include:<ref name="ProcopetBerzigotti2017">{{cite journal|last1=Procopet|first1=Bogdan|last2=Berzigotti|first2=Annalisa|title=Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy|journal=Gastroenterology Report|volume=5|issue=2|year=2017|pages=79–89|issn=2052-0034|doi=10.1093/gastro/gox012}}</ref><ref name="AagaardJensen1982">{{cite journal|last1=Aagaard|first1=J|last2=Jensen|first2=LI|last3=Sorensen|first3=TI|last4=Christensen|first4=U|last5=Burcharth|first5=F|title=Recanalized umbilical vein in portal hypertension|journal=American Journal of Roentgenology|volume=139|issue=6|year=1982|pages=1107–1110|issn=0361-803X|doi=10.2214/ajr.139.6.1107}}</ref><ref name="ChoPatel1995">{{cite journal|last1=Cho|first1=K C|last2=Patel|first2=Y D|last3=Wachsberg|first3=R H|last4=Seeff|first4=J|title=Varices in portal hypertension: evaluation with CT.|journal=RadioGraphics|volume=15|issue=3|year=1995|pages=609–622|issn=0271-5333|doi=10.1148/radiographics.15.3.7624566}}</ref><ref name="BandaliMirakhur2017">{{cite journal|last1=Bandali|first1=Murad Feroz|last2=Mirakhur|first2=Anirudh|last3=Lee|first3=Edward Wolfgang|last4=Ferris|first4=Mollie Clarke|last5=Sadler|first5=David James|last6=Gray|first6=Robin Ritchie|last7=Wong|first7=Jason Kam|title=Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy|journal=World Journal of Gastroenterology|volume=23|issue=10|year=2017|pages=1735|issn=1007-9327|doi=10.3748/wjg.v23.i10.1735}}</ref>
** [[Cirrhosis|Cirrhotic liver]], as shrinkage and atrophy in liver
** Re-canalized [[umbilical vein]]--[[pathognomonic]]
** Dilated [[portal vein]] and/or [[splanchnic]] veins
** [[Esophageal varices]]
** [[Collaterals]] in any [[Abdominal organs|abdominal organ]]
** [[Splenomegaly]]
** [[Ascites]]
'''Portal hypertension'''
{|
|[[Image:Cirrhosis-secondary-to-chronic-hepatitis-c.jpg|thumb|250px|Cirrhosis-Case courtesy of Dr David Cuete, via Radiopaedia.org<ref>From the case <"https://radiopaedia.org/cases/23057">rID: 23057</ref>]]
|[[Image:Cirrhosis111.jpg|thumb|250px|Cirrhosis-Case courtesy of Dr David Cuete, via Radiopaedia.org<ref>From the case <"https://radiopaedia.org/cases/23057">rID: 23057</ref>]]
|[[Image:Cirrhotic-liver-in-wilson-disease.jpg|thumb|230px|Cirrhotic liver in wilson disease-Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org<ref>From the case <"https://radiopaedia.org/cases/5379">rID: 5379</ref>]]
|[[Image:Oesophageal-varices.jpg|thumb|300px|Esophageal varices-Case courtesy of Dr Roberto Schubert, via Radiopaedia.org<ref>From the case <"https://radiopaedia.org/cases/15852">rID: 15852</ref>]]
|}


<gallery>
'''Recanalized Umbilical Vein'''
Image: CT_abdomen_-_liver_cirrhosis_-_01.jpg|Liver cirrhosis as seen on an axial [[computed tomography|CT]] of the abdomen.
 
</gallery>
{|
|[[Image:Uv1.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|[[Image:Uv2.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|[[Image:Uv3.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|- |
|[[Image:Uv4.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|[[Image:Uv5.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|[[Image:Uv6.jpg|thumb|380px|Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810</ref>]]
|}


==References==
==References==
{{reflist|2}}


{{reflist|2}}
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Disease]]


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{{WH}}
{{WS}}
{{WS}}

Latest revision as of 19:24, 13 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Although CT scans are not routinely used in evaluation and diagnosis of cirrhosis, it may show the presence of lobar atrophic and hypertrophic changes in the liver, ascites and varices. CT scans also visualize the presence of tumors, blocked bile ducts and help evaluate the size of the liver.

CT

CT Images

Liver Cirrhosis
Source: Wikimedia commons [2]

Portal hypertension

Cirrhosis-Case courtesy of Dr David Cuete, via Radiopaedia.org[7]
Cirrhosis-Case courtesy of Dr David Cuete, via Radiopaedia.org[8]
Cirrhotic liver in wilson disease-Case courtesy of A.Prof Frank Gaillard, via Radiopaedia.org[9]
Esophageal varices-Case courtesy of Dr Roberto Schubert, via Radiopaedia.org[10]

Recanalized Umbilical Vein

Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]
Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]
Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]
Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]
Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]
Recanalized Umbilical Vein- Case courtesy of Radswiki, via Radiopaedia.org[11]

References

  1. ↑ "Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician". Retrieved 2012-09-07.
  2. ↑ "File:Morbus-Osler-CT-Leber-ax-012.jpg - Wikimedia Commons". External link in |title= (help)
  3. ↑ Procopet, Bogdan; Berzigotti, Annalisa (2017). "Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy". Gastroenterology Report. 5 (2): 79–89. doi:10.1093/gastro/gox012. ISSN 2052-0034.
  4. ↑ Aagaard, J; Jensen, LI; Sorensen, TI; Christensen, U; Burcharth, F (1982). "Recanalized umbilical vein in portal hypertension". American Journal of Roentgenology. 139 (6): 1107–1110. doi:10.2214/ajr.139.6.1107. ISSN 0361-803X.
  5. ↑ Cho, K C; Patel, Y D; Wachsberg, R H; Seeff, J (1995). "Varices in portal hypertension: evaluation with CT". RadioGraphics. 15 (3): 609–622. doi:10.1148/radiographics.15.3.7624566. ISSN 0271-5333.
  6. ↑ Bandali, Murad Feroz; Mirakhur, Anirudh; Lee, Edward Wolfgang; Ferris, Mollie Clarke; Sadler, David James; Gray, Robin Ritchie; Wong, Jason Kam (2017). "Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy". World Journal of Gastroenterology. 23 (10): 1735. doi:10.3748/wjg.v23.i10.1735. ISSN 1007-9327.
  7. ↑ From the case <"https://radiopaedia.org/cases/23057">rID: 23057
  8. ↑ From the case <"https://radiopaedia.org/cases/23057">rID: 23057
  9. ↑ From the case <"https://radiopaedia.org/cases/5379">rID: 5379
  10. ↑ From the case <"https://radiopaedia.org/cases/15852">rID: 15852
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11810">rID: 11810

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