Cirrhosis CT

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

Overview[edit | edit source]

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[edit | edit source]

• Computed tomography is not routinely used in the diagnosis and evaluation of cirrhosis.
• Computed tomography (CT) scanning complements ultrasound imaging.
• CT scan is poor at detecting morphologic changes associated with early cirrhosis, but may accurately demonstrate nodularity and 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.^[1]
• CT may be indicative of underlying etiology due to its classical appearances in some diseases:
  • Budd-Chiari syndrome: hypertrophied caudate lobe
  • Haemochromatosis: excess iron deposition leads to a dramatic increase in hepatic density

• CT scan in patients with cirrhosis may be used to detect:
  • Hepatic nodularity 
  • Atrophy of the right lobe
  • Hypertrophy of the caudate or left lobes
  • Ascites 
  • Varices
  • Liver size
  • Blocked bile ducts
  • Blood flow through the liver
  • Tumors
• Side effects of CT scans:
  • Exposure to contrast and radiation

CT Images[edit | edit source]

• CT of a cirrhotic patient shows a liver with a shrunken, nodular appearance.

• Abdominal CT scan may be helpful in the diagnosis of portal hypertension. Findings on CT scan suggestive of portal hypertension include:^[3][4][5][6]
  • 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 organ
  • Splenomegaly
  • Ascites

Portal hypertension

Recanalized Umbilical Vein

References[edit | edit source]

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