Cirrhosis CT

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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

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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

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* 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

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

Liver Cirrhosis
Source: Wikimedia commons [2]

* 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

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]

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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]

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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

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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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