Imaging
Hepatitis
- Preliminary Diagnosis: Hepatitis
-
I. What imaging technique is first-line for this diagnosis
- II. Describe the advantages and disadvantages of this technique for diagnosis of hepatitis.
-
III. What are the contraindications for the first-line imaging technique?
-
IV. What alternative imaging techniques are available?
- V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of hepatitis.
- VI. What are the contraindications for the alternative imaging techniques?
Preliminary Diagnosis: Hepatitis
I. What imaging technique is first-line for this diagnosis
Ultrasound (US)
II. Describe the advantages and disadvantages of this technique for diagnosis of hepatitis.
Advantages
Real-time examination
Does not use ionizing radiation
Relatively inexpensive
Disadvantages
No specific findings in acute hepatitis
Findings are variable depending on the different etiologic factors that cause hepatic inflammation and stage of liver insult (most common findings are hepatomegaly and the “starry night liver” pattern)
Limited evaluation in obese patients
III. What are the contraindications for the first-line imaging technique?
No significant contraindications exist.
IV. What alternative imaging techniques are available?
MRI
CT
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of hepatitis.
MRI
Advantages
May confirm and further evaluate focal lesions or diffuse alterations of the liver discovered at a prior US examination
Disadvantages
Expensive
Requires significant patient cooperation to minimize motion artifact
CT
Advantages
May confirm and further evaluate focal lesions or diffuse alterations of the liver discovered at a prior US examination
Disadvantages
Exposure to ionizing radiation
VI. What are the contraindications for the alternative imaging techniques?
MRI
Contraindicated in patients with non-MR compatible metallic (ferromagnetic) hardware or foreign bodies, uncooperative or claustrophobic
Need to assess undermining clinical conditions before administration of IV contrast, including allergies and renal function.
MRI/CT
Need to assess undermining clinical conditions before administration of IV contrast, including allergies and renal function
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