Skip to main content
SpringerLink
Log in

Chronic Hepatitis and Liver Fibrosis/Cirrhosis

  • Chapter
  • First Online:
Imaging of the Liver and Intra-hepatic Biliary Tract

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 800 Accesses

Abstract

Liver fibrosis constitutes a potentially reversible significant health problem worldwide, and its identification is fundamental to prevent evolution and to identify complications.

Its most common causes include viral hepatitis, chronic alcoholism and nonalcoholic steatohepatitis (NASH); all these conditions increase scar tissue deposition inside the liver, with a progressive process resulting in cirrhosis.

Liver biopsy represents the gold standard for fibrosis identification, although this technique is not free from possible complications and sampling limitations. Together with biopsy, noninvasive imaging techniques are acquiring an increasingly important role to diagnosis and monitoring of liver fibrosis.

US and CT-based imaging methods depicts morphologic changes of end-stage liver fibrosis, but are limited in evaluating patients with earlier stages of liver disease. Conventional MR imaging scores well in advanced phases of fibrosis, while latest advances in MRI techniques may revolutionize how we image patients with early stage fibrosis.

In addition, Elastosonography assessment of the stiffness of liver parenchyma is a useful tool to identify and evaluate presence and evolution of liver fibrosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Afdhal NH, Nunes D (2004) Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 99(6):1160–1174

    Article  PubMed  Google Scholar 

  • Agnello F, Dioguardi Burgio M, Picone D et al (2016) Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid. World J Gastroenterol 22(1):103–111

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Annet L, Materne R, Danse E et al (2003) Hepatic flow parameters measured with MR imaging and Doppler US: correlations with degree of cirrhosis and portal hypertension. Radiology 229:409–441

    Article  PubMed  Google Scholar 

  • Awaya H, Mitchell DG, Kamishima T et al (2002) Cirrhosis: modified caudate-right lobe ratio. Radiology 224(3):769–774

    Article  PubMed  Google Scholar 

  • Banerjee R, Pavlides M, Tunnicliffe EM et al (2014) Multiparametric magnetic resonance for the noninvasive diagnosis of liver disease. J Hepatol 60:69–77

    Article  PubMed  PubMed Central  Google Scholar 

  • Bedossa P, Dargère D, Paradis V (2003) Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 38:1449–1457

    Article  PubMed  Google Scholar 

  • Brancatelli G, Federle MP, Ambrosini R et al (2007) Cirrhosis: CT and MR imaging evaluation. Eur J Radiol 61:57–69

    Article  PubMed  Google Scholar 

  • Bülow R, Mensel B, Meffert P et al (2013) Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron. Eur Radiol 23:1281–1128

    Article  PubMed  Google Scholar 

  • Cece H, Ercan A, Yıldız S et al (2013) The use of DWI to assess spleen and liver quantitative ADC changes in the detection of liver fibrosis stages in chronic viral hepatitis. Eur J Radiol 82:e307–e312

    Article  PubMed  Google Scholar 

  • Colloredo G, Guido M, Sonzogni A, Leandro G (2003) Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease. J Hepatol 39(2):239–244

    Article  PubMed  Google Scholar 

  • D’Onofrio M, Gallotti A, Pozzi Mucelli R (2010) Tissue quantification with acoustic radiation force impulse imaging: measurement repeatability and normal values in the healthy liver. Am J Roentgenol 195:132–136

    Article  Google Scholar 

  • D’Onofrio M, Crosara S, De Robertis R et al (2013) Acoustic radiation force impulse of the liver. World J Gastroenterol 19(30):4841–4849

    Article  PubMed  PubMed Central  Google Scholar 

  • De Robertis R, D’Onofrio M, Demozzi E et al (2014) Noninvasive diagnosis of cirrhosis: a review of different imaging modalities. World J Gastroenterol 20(23):7231–7241

    Article  PubMed  PubMed Central  Google Scholar 

  • Desmet VJ, Gerber M, Hoofnagle JH et al (1999) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19(6):1513–1520

    Article  Google Scholar 

  • Dodd GD 3rd, Baron RL, Oliver JH 3rd, Federle MP (1999) Spectrum of imaging findings of the liver in end-stage cirrhosis: part I gross morphology and diffuse abnormalities. AJR 173(4):1031–1036

    Article  PubMed  Google Scholar 

  • Faria SC, Ganesan K, Mwangi I et al (2009) MR imaging of liver fibrosis: current state of the art. Radiographics 29:1615–1635

    Article  PubMed  Google Scholar 

  • Fierbinteanu-Braticevici C, Andronescu D, Usvat R et al (2009) Acoustic radiation force imaging sonoelastography for noninvasive staging of liver fibrosis. World J Gastroenterol 15:5525–5532

    Article  PubMed  PubMed Central  Google Scholar 

  • Friedman SL, Bansal MB (2006) Reversal of hepatic fibrosis - fact or fantasy? Hepatology 43:S82–S88

    Article  CAS  PubMed  Google Scholar 

  • Harbin WP, Robert NJ, Ferrucci JT Jr (1980) Diagnosis of cirrhosis based on regional changes in hepatic morphology: a radiological and pathological analysis. Radiology 135(2):273–283

    Article  CAS  PubMed  Google Scholar 

  • Hshiao MH, Chen PC, Jao JC et al (2012) Quantifying liver cirrhosis by extracting significant features from MRI T2 image. Scientific World Journal 2012:343847

    Article  PubMed  PubMed Central  Google Scholar 

  • Imbert-Bismut F, Ratziu V, Pieroni L et al (2001) Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet 357(9262):1069–1075

    Article  CAS  PubMed  Google Scholar 

  • Ishak K, Baptista A, Bianchi L et al (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22(6):696–699

    Article  CAS  PubMed  Google Scholar 

  • Ito K, Mitchell DG, Gabata T, Hussain SM (1999) Expanded gallbladder fossa: simple MR imaging sign of cirrhosis. Radiology 211:723–726

    Article  CAS  PubMed  Google Scholar 

  • Ito K, Mitchell DG (2004) Imaging diagnosis of cirrhosis and chronic hepatitis. Intervirology 47(3–5):134–143

    Article  PubMed  Google Scholar 

  • Le Bihan D (1990) Diffusion/perfusion MR imaging of the brain: from structure to function. Radiology 177:328–329

    Article  PubMed  Google Scholar 

  • Marcellin P, Asselah T, Boyer N (2002) Fibrosis and disease progression in hepatitis C. Hepatology 36:S47–S56

    PubMed  Google Scholar 

  • Martin DR (2002) Magnetic resonance imaging of diffuse liver diseases. Top Magn Reson Imaging 13(3):151–163

    Article  PubMed  Google Scholar 

  • Mehmet RO, Ahmet KP, Pinar GB et al (2013) Diffusion weighted MRI in chronic viral hepatitis: correlation between ADC values and histopathological scores. Insights Imaging 4:339–345

    Article  Google Scholar 

  • Parkin MD, Bray F, Ferlay J et al (2002) Global cancer statistics. CA Cancer J Clin 55:74–108

    Article  Google Scholar 

  • Rustogi R, Horowitz J, Harmath C et al (2012) Accuracy of MR elastography and anatomic MR imaging features in the diagnosis of severe hepatic fibrosis and cirrhosis. J Magn Reson Imaging 35(6):1356–1364

    Article  PubMed  PubMed Central  Google Scholar 

  • Schuppan D, Afdhal NH (2008) Liver cirrhosis. Lancet 371:838–851

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shaheen NJ, Hansen RA, Morgan DR et al (2006) The burden of gastrointestinal and liver diseases. Am J Gastroenterol 101:2128–2138

    Article  PubMed  Google Scholar 

  • Standish RA, Cholongitas E, Dhillon A et al (2006) An appraisal of the histopathological assessment of liver fibrosis. Gut 55:569–578

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis and clinical applications. J Magn Reson Imaging 37(3):544–555

    Article  PubMed  PubMed Central  Google Scholar 

  • Talwalkar JA (2006) Shall we bury the sword? Imaging of hepatic fibrosis. Gastroenterology 131:1669–1167

    Article  PubMed  Google Scholar 

  • Talwalkar JA, Yin M, Fidler JL et al (2008) Magnetic resonance imaging of hepatic fibrosis: emerging clinical applications. Hepatology 47:332–342

    Article  PubMed  Google Scholar 

  • Tamada T, Ito K, Higaki A et al (2011a) Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers. Eur J Radiol 80:e311–e316

    Article  PubMed  Google Scholar 

  • Tamada T, Ito K, Sone T et al (2011b) Gd-EOBDTPA enhanced MR imaging: evaluation of biliary and renal excretion in normal and cirrhotic livers. Eur J Radiol 80:207–211

    Article  Google Scholar 

  • Taouli B, Tolia AJ, Losada M et al (2007) Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. AJR 189(4):799–806

    Article  PubMed  Google Scholar 

  • Terjung B, Lemnitzer I, Dumoulin FL et al (2003) Bleeding complications after percutaneous liver biopsy. An analysis of risk factors. Digestion 67:138–145

    Article  PubMed  Google Scholar 

  • Thiese ND, Bodenheimer HC, Ferrell LD (2006) Acute and chronic viral hepatitis. In: Burt AD, Portmann BC, Ferrell LD (eds) MacSween’s pathology of the liver. Chapter 8, 5th edn. Churchill Livingstone, Edinburgh, Scotland

    Google Scholar 

  • Wallace K, Burt AD, Wright MC (2008) Liver fibrosis. Biochem Genet 411(1):1–18

    CAS  Google Scholar 

  • Wong VW, Vergniol J, Wong GL et al (2010) Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 51:454–462

    Article  CAS  PubMed  Google Scholar 

  • Yin M, Talwalkar JA, Glaser KJ et al (2007) A preliminary assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5(10):1207–1213

    Article  PubMed  PubMed Central  Google Scholar 

  • Yulri P, Seong Hyun K, Seung Hoon K et al (2010) Gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI versus gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for preoperatively detecting hepatocellular carcinoma: an initial experience. Korean J Radiol 11(4):433–440

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istituto di Radiologia, Policlinico GB Rossi, Università di Verona, Verona, Italy

    Sara Mehrabi, Enza Genco, Mariacristina Maturi & Mirko D’Onofrio

Authors
  1. Sara Mehrabi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enza Genco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariacristina Maturi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mirko D’Onofrio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mirko D’Onofrio .

Editor information

Editors and Affiliations

  1. Radiology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy

    Emilio Quaia

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mehrabi, S., Genco, E., Maturi, M., D’Onofrio, M. (2021). Chronic Hepatitis and Liver Fibrosis/Cirrhosis. In: Quaia, E. (eds) Imaging of the Liver and Intra-hepatic Biliary Tract. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-38983-3_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-38983-3_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-38982-6

  • Online ISBN: 978-3-030-38983-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation