Cirrhosis echocardiography or ultrasound: Difference between revisions
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==Echocardiography== | ==Echocardiography== | ||
[[Echocardiography|Echocardiogram]] may be helpful in measuring the ejection fraction, and [[ischemia|ischemic]] and [[Hypokinesia|hypokinetic]] areas of the [[ventricle (heart)|ventricles]] in establishing diagnosis of [[congestive cardiac failure]] as a cause of liver cirrhosis. | *[[Echocardiography|Echocardiogram]] may be helpful in measuring the ejection fraction, and [[ischemia|ischemic]] and [[Hypokinesia|hypokinetic]] areas of the [[ventricle (heart)|ventricles]] in establishing diagnosis of [[congestive cardiac failure]] as a cause of liver cirrhosis. | ||
*Contrast echocardiography | |||
**Intravenous microbubbles (> 10 micrometers in diameter) from agitated [[normal saline]] that are normally obstructed by pulmonary capillaries (normally <8 to 15 micrometers) rapidly transit the lung and appear in the [[left atrium]] of the heart within 7 heart beats | |||
**Similarly, intravenous [[technetium]]-99m–labeled [[albumin]] may transit the lungs and appear in the kidney and brain | |||
==Ultrasound== | ==Ultrasound== | ||
Revision as of 19:17, 6 September 2012
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Cirrhosis Microchapters |
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Cirrhosis echocardiography or ultrasound On the Web |
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American Roentgen Ray Society Images of Cirrhosis echocardiography or ultrasound |
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Risk calculators and risk factors for Cirrhosis echocardiography or ultrasound |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
On ultrasonography, changes in liver contours and nodularity may be evident. The echo texture may appear coarsened along with increase in echogenecity from focal fatty changes and irregular appearing areas. It can also be used to screen for hepatocellular carcinoma, portal hypertension and Budd-Chiari syndrome.
Echocardiography
- Echocardiogram may be helpful in measuring the ejection fraction, and ischemic and hypokinetic areas of the ventricles in establishing diagnosis of congestive cardiac failure as a cause of liver cirrhosis.
- Contrast echocardiography
- Intravenous microbubbles (> 10 micrometers in diameter) from agitated normal saline that are normally obstructed by pulmonary capillaries (normally <8 to 15 micrometers) rapidly transit the lung and appear in the left atrium of the heart within 7 heart beats
- Similarly, intravenous technetium-99m–labeled albumin may transit the lungs and appear in the kidney and brain
Ultrasound
Following changes may be noted:
- Changes in liver contour
- Nodularity
- Increase in echogenecity from focal fatty infiltration
- Vascular changes:
- Flow across both portal and systemic circulation increases
- Resistive Index increases in end stage liver disease
- Vessels appear elongated and tortuous, called "corkscrewing" of the vessels
- Doppler ultrasound may show spontaneous shunts
- Splenomegaly and collaterals from portal hypertension may be noted.
A new type of device, the FibroScan (transient elastography), uses elastic waves to determine liver stiffness which theoretically can be converted into a liver score based on the METAVIR scale. The FibroScan produces an ultrasound image of the liver (from 20-80mm) along with a pressure reading (in kPa.) The test is much faster than a biopsy (usually last 2.5-5 minutes) and is completely painless. It shows reasonable corellation with the severity of cirrhosis.[1] [2]
References
- ↑ Foucher J, Chanteloup E, Vergniol J; et al. (2006). "Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study". Gut. 55 (3): 403–8. doi:10.1136/gut.2005.069153. PMID 16020491.
- ↑ Xie L, Chen X, Guo Q, Dong Y, Guang Y, Zhang X (2012). "Real-time elastography for diagnosis of liver fibrosis in chronic hepatitis B". Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 31 (7): 1053–60. PMID 22733854. Unknown parameter
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