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Hepatic Cirrhosis
Nicole Roy, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Chronic liver disease characterized by diffuse parenchymal necrosis with extensive fibrosis & regenerative nodule formation
              • Common end response of liver to variety of insults & injuries

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • CT Findings

                • MR Findings

                  • Elastographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Kennedy P et al: Quantitative elastography methods in liver disease: current evidence and future directions. Radiology. 286(3):738-63, 2018
                                            2. Horowitz JM et al: Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel. Abdom Radiol (NY). 42(8):2037-53, 2017
                                            3. Srinivasa Babu A et al: Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics. 36(7):1987-2006, 2016
                                            4. Barr RG et al: Elastography assessment of liver fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology. 276(3):845-61, 2015
                                            5. Beland MD et al: A pilot study estimating liver fibrosis with ultrasound shear-wave elastography: does the cause of liver disease or location of measurement affect performance? AJR Am J Roentgenol. 203(3):W267-73, 2014
                                            6. Ferraioli G et al: Shear wave elastography for evaluation of liver fibrosis. J Ultrasound Med. 33(2):197-203, 2014
                                            7. Buadu A et al: Small liver nodule detection with a high-frequency transducer in patients with chronic liver disease: report of 3 cases. J Ultrasound Med. 32(2):355-9, 2013
                                            8. Irshad A et al: Current role of ultrasound in chronic liver disease: surveillance, diagnosis and management of hepatic neoplasms. Curr Probl Diagn Radiol. 41(2):43-51, 2012
                                            9. Ridolfi F et al: Contrast-enhanced ultrasound evaluation of hepatic microvascular changes in liver diseases. World J Gastroenterol. 18(37):5225-30, 2012
                                            10. Shi Y et al: Quantitative diagnosis of early-stage liver cirrhosis with contrast-enhanced ultrasound--a clinical study. Adv Clin Exp Med. 21(3):385-90, 2012
                                            11. Friedrich-Rust M et al: Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 252(2):595-604, 2009
                                            12. Goyal N et al: Non-invasive evaluation of liver cirrhosis using ultrasound. Clin Radiol. 64(11):1056-66, 2009
                                            13. Vessal S et al: Hepatic vein morphology: a new sonographic diagnostic parameter in the investigation of cirrhosis? J Ultrasound Med. 28(9):1219-27, 2009
                                            14. Haktanir A et al: Value of Doppler sonography in assessing the progression of chronic viral hepatitis and in the diagnosis and grading of cirrhosis. J Ultrasound Med. 24(3):311-21, 2005
                                            15. Nicolau C et al: Gray-scale ultrasound in hepatic cirrhosis and chronic hepatitis: diagnosis, screening, and intervention. Semin Ultrasound CT MR. 23(1):3-18, 2002
                                            16. Tchelepi H et al: Sonography of diffuse liver disease. J Ultrasound Med. 21(9):1023-32; quiz 1033-4, 2002
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Chronic liver disease characterized by diffuse parenchymal necrosis with extensive fibrosis & regenerative nodule formation
                                                        • Common end response of liver to variety of insults & injuries

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Elastographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Kennedy P et al: Quantitative elastography methods in liver disease: current evidence and future directions. Radiology. 286(3):738-63, 2018
                                                                                      2. Horowitz JM et al: Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel. Abdom Radiol (NY). 42(8):2037-53, 2017
                                                                                      3. Srinivasa Babu A et al: Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics. 36(7):1987-2006, 2016
                                                                                      4. Barr RG et al: Elastography assessment of liver fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology. 276(3):845-61, 2015
                                                                                      5. Beland MD et al: A pilot study estimating liver fibrosis with ultrasound shear-wave elastography: does the cause of liver disease or location of measurement affect performance? AJR Am J Roentgenol. 203(3):W267-73, 2014
                                                                                      6. Ferraioli G et al: Shear wave elastography for evaluation of liver fibrosis. J Ultrasound Med. 33(2):197-203, 2014
                                                                                      7. Buadu A et al: Small liver nodule detection with a high-frequency transducer in patients with chronic liver disease: report of 3 cases. J Ultrasound Med. 32(2):355-9, 2013
                                                                                      8. Irshad A et al: Current role of ultrasound in chronic liver disease: surveillance, diagnosis and management of hepatic neoplasms. Curr Probl Diagn Radiol. 41(2):43-51, 2012
                                                                                      9. Ridolfi F et al: Contrast-enhanced ultrasound evaluation of hepatic microvascular changes in liver diseases. World J Gastroenterol. 18(37):5225-30, 2012
                                                                                      10. Shi Y et al: Quantitative diagnosis of early-stage liver cirrhosis with contrast-enhanced ultrasound--a clinical study. Adv Clin Exp Med. 21(3):385-90, 2012
                                                                                      11. Friedrich-Rust M et al: Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 252(2):595-604, 2009
                                                                                      12. Goyal N et al: Non-invasive evaluation of liver cirrhosis using ultrasound. Clin Radiol. 64(11):1056-66, 2009
                                                                                      13. Vessal S et al: Hepatic vein morphology: a new sonographic diagnostic parameter in the investigation of cirrhosis? J Ultrasound Med. 28(9):1219-27, 2009
                                                                                      14. Haktanir A et al: Value of Doppler sonography in assessing the progression of chronic viral hepatitis and in the diagnosis and grading of cirrhosis. J Ultrasound Med. 24(3):311-21, 2005
                                                                                      15. Nicolau C et al: Gray-scale ultrasound in hepatic cirrhosis and chronic hepatitis: diagnosis, screening, and intervention. Semin Ultrasound CT MR. 23(1):3-18, 2002
                                                                                      16. Tchelepi H et al: Sonography of diffuse liver disease. J Ultrasound Med. 21(9):1023-32; quiz 1033-4, 2002