Alcoholic hepatitis CT
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
CT scan is usually performed among patients with Alcoholic Hepatitis to exclude other abnormalities including neoplasm, biliary obstruction or infiltrative liver disease.CT scan can predict severity and outcome of Alcoholic Hepatitis by presence of splenomegaly, ascites, varices, liver length to mid clavicular line, decreased liver attenuation, liver to spleen attenuation ratio and increased liver heterogenecity.
CT
- CT scan is usually performed among patients with Alcoholic Hepatitis to exclude other abnormalities including neoplasm, biliary obstruction or infiltrative liver disease.[1][2]
- CT scan can predict severity and outcome of Alcoholic Hepatitis by presence of the following findings: [3][4][5]
- Splenomegaly, defined as spleen dimension ≥ 13 cm
- Degree of Ascites; mild , moderate or severe
- Varices; defined as moderate if esophageal varices < 3 mm or paraesophageal varices < 5 mm, severe varices defined as esophageal varices > 3 mm or paraesophageal varices > 5 mm [6]
- Liver length to mid clavicular line
- Decreased Liver attenuation around portal system
- Liver to spleen attenuation ratio > 10 hounsfield units is suggestive of hepatic steatosis [7]
- Increased Liver heterogenecity
References
- ↑ Chedid A, Mendenhall CL, Gartside P, French SW, Chen T, Rabin L (1991). "Prognostic factors in alcoholic liver disease. VA Cooperative Study Group". Am J Gastroenterol. 86 (2): 210–6. PMID 1992635.
- ↑ Suk KT (2014). "Hepatic venous pressure gradient: clinical use in chronic liver disease". Clin Mol Hepatol. 20 (1): 6–14. doi:10.3350/cmh.2014.20.1.6. PMC 3992331. PMID 24757653.
- ↑ Bloom PP, Mojtahed A, Bethea ED, Knooihuizen SA, Choi J, Dienstag JL; et al. (2020). "Computed Tomography Findings as a Novel Predictor of Alcohol-Associated Hepatitis Outcomes". Dig Dis Sci. 65 (1): 312–321. doi:10.1007/s10620-019-05721-4. PMID 31363954.
- ↑ Maruzzelli L, Parr AJ, Miraglia R, Tuzzolino F, Luca A (2014). "Quantification of hepatic steatosis: a comparison of computed tomography and magnetic resonance indices in candidates for living liver donation". Acad Radiol. 21 (4): 507–13. doi:10.1016/j.acra.2014.01.007. PMID 24594420.
- ↑ Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW; et al. (2006). "Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment". Radiology. 239 (1): 105–12. doi:10.1148/radiol.2391050361. PMID 16484355.
- ↑ Lee JY, Kim TY, Jeong WK, Kim Y, Kim J, Kim KW; et al. (2014). "Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis". Dig Dis Sci. 59 (9): 2333–43. doi:10.1007/s10620-014-3149-8. PMID 24723070.
- ↑ Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980). "Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease". Radiology. 137 (3): 727–9. doi:10.1148/radiology.137.3.6934563. PMID 6934563.