Cirrhosis: CT and MR imaging evaluation

Brancatelli, Giuseppe; Federle, Michael P.; Ambrosini, Roberta; Lagalla, Roberto; Carriero, Alessandro; Midiri, Massimo; Vilgrain, Valérie

doi:10.1016/j.ejrad.2006.11.003

« Previous Next »European Journal of Radiology
Volume 61, Issue 1 , Pages 57-69, January 2007

Cirrhosis: CT and MR imaging evaluation

Giuseppe Brancatelli
- Sezione di Radiologia, Ospedale Specializzato in Gastroenterologia, “Saverio de Bellis”—IRCCS, 70013 Castellana Grotte (Bari), Italy
- Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Università di Palermo, Via del Vespro 127, 90127 Palermo, Italy
- Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, 15213 Pittsburgh, PA, USA
- Corresponding author at: Via Villaermosa 29, 90139 Palermo, Italy. Tel.: +39 3291828155; fax: +39 0916552325.
Michael P. Federle
- Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, 15213 Pittsburgh, PA, USA
Roberta Ambrosini
- Department of Diagnostic and Interventional Radiology, “Maggiore della Carità” University Hospital, “A.Avogadro” Eastern Piemonte University, Corso Mazzini 18, Novara, Italy
Roberto Lagalla
- Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Università di Palermo, Via del Vespro 127, 90127 Palermo, Italy
Alessandro Carriero
- Department of Diagnostic and Interventional Radiology, “Maggiore della Carità” University Hospital, “A.Avogadro” Eastern Piemonte University, Corso Mazzini 18, Novara, Italy
Massimo Midiri
- Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Università di Palermo, Via del Vespro 127, 90127 Palermo, Italy
Valérie Vilgrain
- Service de Radiologie, Hopital Beaujon, 100 Boulevard du General Leclerc, 92118 Clichy, France

Received 7 July 2006; accepted 2 November 2006.

Abstract

In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and peribiliary cysts. We show different conditions causing liver morphology changes that can mimic cirrhosis, such as congenital hepatic fibrosis, “pseudo-cirrhosis” due to breast metastases treated with chemotherapy, Budd-Chiari syndrome, sarcoidosis and cavernous transformation of the portal vein.

Keywords: Liver, Cirrhosis, Computed tomography, Magnetic resonance imaging