Prediction of liver cirrhosis, using diagnostic imaging tools

Abstract

Early diagnosis of liver cirrhosis is important. Ultrasoundguided liver biopsy is the gold standard for diagnosis of liver cirrhosis. However, its invasiveness and sampling bias limit the applicability of the method. Basic imaging for the diagnosis of liver cirrhosis has developed over the last few decades, enabling early detection of morphological changes of the liver by ultrasonography (US), computed tomography, and magnetic resonance imaging (MRI). They are also accurate diagnostic methods for advanced liver cirrhosis, for which early diagnosis is difficult. There are a number of ways to compensate for this difficulty, including texture analysis to more closely identify the homogeneity of hepatic parenchyma, elastography to measure the stiffness and elasticity of the liver, and perfusion studies to determine the blood flow volume, transit time, and velocity. Amongst these methods, elastography using US and MRI was found to be slightly easier, faster, and able to provide an accurate diagnosis. Early diagnosis of liver cirrhosis using MRI or US elastography is therefore a realistic alternative, but further research is still needed.

Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score

“…The requirement for informed patient consent was waived because of the retrospective nature of the study. The diagnosis of cirrhosis was made by a combination of clinical history and typical sonographic findings, including bright and coarsened liver echotexture, nodular liver capsule, and widened fissures …”

Utility of electronic medical recordbased fibrosis scores in predicting advanced cirrhosis in patients with hepatitic C virus infection

“…In our review of the radiological literature, a nodular liver (often described as "undulating liver surface") and the presence of porto-systemic collaterals were the two most frequently used imaging criteria for cirrhosis. [7][8][9] Our study reveals a modest ability of the seven scores to detect advanced cirrhosis, with sensitivities ranging from 0.66 to 0.84, excluding Fibroindex and Forns. Based on this result, the serum-based testing would identify majority of the patients, but would miss approximately one third of patients in this category.…”

“…Such modalities include parenchymal texture analyses, elastography and vascular perfusion studies. [9] However, such measurements would require additional testing of large numbers of patients, which in turn would result in significant logistical obstacles and delays. By comparison, our approach has the advantage of utilizing already existing, "real life" imaging data that can be obtained from standard electronic medical records.…”

Curriculum for the Performance of Ultrasound‐Guided Procedures

“…When accessing mediastinal lesions under real‐time ultrasound guidance, it is of the utmost importance to avoid the various vascular structures; therefore, intermittent color Doppler imaging to plan the needle trajectory and during needle advancement is beneficial. Percutaneous USG procedures play a major role for the workup and treatment assessment of liver cirrhosis, liver transplant rejection, and liver lesions. For the assessment and staging of liver cirrhosis, USG biopsy remains the reference standard . Furthermore, for the evaluation of abnormal liver function tests, posttransplant USG random liver biopsy is helpful to determine the etiology of underlying liver disease.…”

“…For the assessment and staging of liver cirrhosis, USG biopsy remains the reference standard. 25 Furthermore, for the evaluation of abnormal liver function tests, posttransplant USG random liver biopsy is helpful to determine the etiology of underlying liver disease. Ultrasound guidance over CT guidance for biopsy is preferred if the lesion can be seen under standard gray scale ultrasound.…”