Liver fibrosis, cirrhosis, and cirrhosis-related nodules: Imaging diagnosis and surveillance

Diagn Interv Imaging. 2017 Jun;98(6):455-468. doi: 10.1016/j.diii.2017.03.003. Epub 2017 Apr 29.

Abstract

Although biological scores and elastography continue to yield the best results, imaging retains a crucial role in the diagnosis of liver fibrosis and cirrhosis. First, digestive symptoms or biological liver test abnormalities often lead the referring physician to request an abdominal ultrasound, and with an experienced operator, accuracy of ultrasound can reach 85% for the diagnosis of severe fibrosis or cirrhosis. Second, imaging could lead to discovery of nonsymptomatic fibrosis or cirrhosis, with an estimated prevalence of 0.5-2.8% in the population. After diagnosis, imaging is central in the follow-up of cirrhosis. It is used to detect worsening of portal hypertension and hepatocellular carcinoma (HCC). Because many nodules are present in a cirrhotic liver, familiarity with the features of HCC can facilitate noninvasive diagnosis and early and accurate treatment.

Keywords: Cirrhosis; Elastography; Hepatocellular carcinoma; Portal hypertension; Ultrasound.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Blood Flow Velocity
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Colitis / diagnostic imaging
  • Diagnostic Imaging / methods*
  • Esophageal and Gastric Varices / diagnostic imaging
  • Gallbladder / diagnostic imaging
  • Gallbladder / pathology
  • Hepatic Veins / diagnostic imaging
  • Humans
  • Hypertension, Portal / diagnostic imaging
  • Hypertrophy
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Neoplasms / diagnostic imaging
  • Portal System / diagnostic imaging