What is the role of imaging studies in the diagnosis of hepatitis B (HBV) (Hep B) infection?

Updated: Aug 01, 2018
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Findings on imaging studies are briefly reviewed according to the disease stage.

Acute and chronic hepatitis B disease

Performing abdominal ultrasonography, computed tomography (CT) scanning, or magnetic resonance imaging (MRI) in patients with hepatitis B is important to help exclude biliary obstruction (see the following images). Nonspecific findings include increased echogenicity of the liver parenchyma.

Radiologic studies may be useful in all stages of Radiologic studies may be useful in all stages of hepatitis B infection. Ultrasonography, computed tomography (CT) scanning, or magnetic resonance imaging (MRI) may exclude biliary obstruction in acute infection. In chronic disease, ultrasonograms may show nonspecific increased echogenicity of the liver parenchyma. In patients with long-standing disease, CT imaging may be used to detect cirrhosis or hepatocellular carcinoma (as shown).
Long-standing cirrhosis leads to progressive repla Long-standing cirrhosis leads to progressive replacement of liver parenchyma with fibrotic tissue. Over time, the liver contracts and develops a lobulated contour. These changes are readily apparent on cross-sectional imaging. This contrast-enhanced computed tomography (CT) scan demonstrates extensive cirrhosis, as well as malignant hepatocellular lesions (arrow).

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