Cirrhosis echocardiography or ultrasound

Cirrhosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Cirrhosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Tertiary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case studies
Case #1
Cirrhosis echocardiography or ultrasound On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Cirrhosis echocardiography or ultrasound All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Cirrhosis echocardiography or ultrasound
CDC on Cirrhosis echocardiography or ultrasound
Cirrhosis echocardiography or ultrasound in the news
Blogs on Cirrhosis echocardiography or ultrasound
Directions to Hospitals Treating Cirrhosis
Risk calculators and risk factors for Cirrhosis echocardiography or ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

On ultrasonography, changes in liver contours and nodularity may be evident. The echo texture may appear coarsened along with increase in echogenecity from focal fatty changes and irregular appearing areas. It can also be used to screen for hepatocellular carcinoma, portal hypertension and Budd-Chiari syndrome.

Echocardiography

• Echocardiogram may be helpful in measuring the ejection fraction, and ischemic and hypokinetic areas of the ventricles in establishing diagnosis of congestive cardiac failure as a cause of liver cirrhosis.
• Contrast echocardiography
  • Intravenous microbubbles (> 10 micrometers in diameter) from agitated normal saline that are normally obstructed by pulmonary capillaries (normally <8 to 15 micrometers) rapidly transit the lung and appear in the left atrium of the heart within 7 heart beats
  • Similarly, intravenous technetium-99m–labeled albumin may transit the lungs and appear in the kidney and brain

Ultrasound

Following changes may be noted:

• Changes in liver contour
• Nodularity
• Increase in echogenecity from focal fatty infiltration
• Vascular changes:
  • Flow across both portal and systemic circulation increases
  • Resistive Index increases in end stage liver disease
  • Vessels appear elongated and tortuous, called "corkscrewing" of the vessels
  • Doppler ultrasound may show spontaneous shunts
• Splenomegaly and collaterals from portal hypertension may be noted.

Transient Elastography

A new type of device, the FibroScan (transient elastography), uses elastic waves to determine liver stiffness which theoretically can be converted into a liver score based on the METAVIR scale. The FibroScan produces an ultrasound image of the liver (from 20-80mm) along with a pressure reading (in kPa.) The test is much faster than a biopsy (usually last 2.5-5 minutes) and is completely painless. It shows reasonable corellation with the severity of cirrhosis.