Alcoholic hepatitis CT: Difference between revisions
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{{CM}} {{AE}} {{S.M}} | {{CM}} {{AE}} {{S.M}} | ||
==Overview== | ==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, [[liver]] [[attenuation]], [[spleen]] [[attenuation]], and [[liver]] [[heterogenecity]]. | |||
== CT== | == CT== | ||
* [[CT scan]] is usually performed among [[patients]] with [[Alcoholic Hepatitis]] to exclude other abnormalities including [[neoplasm]], [[biliary]] [[obstruction]] or [[infiltrative]] [[liver]] [[disease]]. | * [[CT scan]] is usually performed among [[patients]] with [[Alcoholic Hepatitis]] to exclude other abnormalities including [[neoplasm]], [[biliary]] [[obstruction]] or [[infiltrative]] [[liver]] [[disease]].<ref name="pmid1992635">{{cite journal| author=Chedid A, Mendenhall CL, Gartside P, French SW, Chen T, Rabin L| title=Prognostic factors in alcoholic liver disease. VA Cooperative Study Group. | journal=Am J Gastroenterol | year= 1991 | volume= 86 | issue= 2 | pages= 210-6 | pmid=1992635 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1992635 }} </ref><ref name="pmid24757653">{{cite journal| author=Suk KT| title=Hepatic venous pressure gradient: clinical use in chronic liver disease. | journal=Clin Mol Hepatol | year= 2014 | volume= 20 | issue= 1 | pages= 6-14 | pmid=24757653 | doi=10.3350/cmh.2014.20.1.6 | pmc=3992331 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24757653 }} </ref> | ||
*[[CT scan]] can predict [[severity]] and [[outcome]] of [[Alcoholic Hepatitis]] by presence of the following findings: | *[[CT scan]] can predict [[severity]] and [[outcome]] of [[Alcoholic Hepatitis]] by presence of the following findings:<ref name="pmid24594420">{{cite journal| author=Maruzzelli L, Parr AJ, Miraglia R, Tuzzolino F, Luca A| title=Quantification of hepatic steatosis: a comparison of computed tomography and magnetic resonance indices in candidates for living liver donation. | journal=Acad Radiol | year= 2014 | volume= 21 | issue= 4 | pages= 507-13 | pmid=24594420 | doi=10.1016/j.acra.2014.01.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24594420 }} </ref><ref name="pmid16484355">{{cite journal| author=Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW | display-authors=etal| title=Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. | journal=Radiology | year= 2006 | volume= 239 | issue= 1 | pages= 105-12 | pmid=16484355 | doi=10.1148/radiol.2391050361 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16484355 }} </ref> | ||
** [[Splenomegaly]], defined as [[spleen]] dimension ≥ 13 cm | ** [[Splenomegaly]], defined as [[spleen]] dimension ≥ 13 cm | ||
** [[Ascites]] | ** [[Ascites]] | ||
** [[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 | ** [[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 <ref name="pmid24723070">{{cite journal| author=Lee JY, Kim TY, Jeong WK, Kim Y, Kim J, Kim KW | display-authors=etal| title=Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis. | journal=Dig Dis Sci | year= 2014 | volume= 59 | issue= 9 | pages= 2333-43 | pmid=24723070 | doi=10.1007/s10620-014-3149-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24723070 }} </ref> | ||
** [[Liver]] length to mid [[clavicular]] line | ** [[Liver]] length to mid [[clavicular]] line | ||
** [[Liver]] [[attenuation]], measured approximately 5 cm2 regions of interest in the right, central, and left [[liver]] at the level of the [[portal]] [[vein]] | ** [[Liver]] [[attenuation]], measured approximately 5 cm2 regions of interest in the right, central, and left [[liver]] at the level of the [[portal]] [[vein]] |
Revision as of 02:21, 31 July 2021
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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, liver attenuation, spleen attenuation, and 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]
- Splenomegaly, defined as spleen dimension ≥ 13 cm
- Ascites
- 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 [5]
- Liver length to mid clavicular line
- Liver attenuation, measured approximately 5 cm2 regions of interest in the right, central, and left liver at the level of the portal vein
- Spleen attenuation, measured approximately 5 cm2 regions of interest in the center of spleen
- Liver heterogenecity, mild heterogenecity considered as if 1 to 50% of hepatic parenchyma was heterogenous, more than 50% of heterogenous area considered moderate to severeheterogenecity
hepatic parenchyma was heterogenous
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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.
- ↑ 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.