Hepatitis

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