Radiological diagnostics of liver cirrhosis and portal hypertension

Abstract:

All three main modalities in modern radiological diagnostics – Doppler ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) – play an important role in the diagnosis of portal hypertension, its manifestations and concomitant pathologies, such as liver cirrhosis and hepatocellular carcinoma. Doppler ultrasound is usually the first diagnostic modality to be used due to its accessibility, safety and good results in the analysis of liver parenchyma and larger vascular structures, i.e., the portal vein, its chief tributaries and hepatic veins. Modern CT and CT angiography with the application of IV contrast are excellent in everyday clinical practice. These modalities are used for detailed analysis of all parts of liver parenchyma and vascular structures and are used for confirmation of suspicious ultrasound findings and solving more complex clinical problems. MRI with the application of IV contrast and a greater possibility of multiphase acquisition is mostly useful in characterising liver lesions unexplained by CT. MR angiography with sophisticated flow measuring techniques will see increased use in the future. 

Key words:
angiography; hypertension, portal; liver cirrhosis; magnetic resonance imaging; tomography, X-ray computed; ultrasonics