What is the role of CT scanning in the evaluation of acute liver failure (ALF)?

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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Answer

Computed tomography (CT) scanning (or magnetic resonance imaging [MRI]) of the abdomen may be required for further definition of hepatic anatomy and to help the clinician exclude other intra-abdominal processes, particularly if the patient has developed massive ascites, if the patient is obese, or if transplantation is being planned.

Intravenous contrast media may compromise renal function. Consider performing a contrast-free study.

CT scanning of the head may help identify cerebral edema, although CT scans do not reliably demonstrate evidence of edema, especially at early stages. Head imaging with CT scanning is also used to exclude other causes of decline in the mental status, such as intracranial mass lesions (especially hematomas) that may mimic edema from fulminant hepatic failure. It can also exclude subdural hematomas (see the image below).

Subacute subdural hematoma with extension into the Subacute subdural hematoma with extension into the anterior interhemispheric cistern. Note that the sulci do not contain the spread of these hemorrhages.

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