What are the likely imaging findings of cirrhosis in patients with 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

Imaging findings in cirrhosis include coarse echogenicity of the liver, with a nodular appearance, and findings compatible with portal hypertension (eg, varices, splenomegaly, ascites, pleural effusion [ie, hepatic hydrothorax]).

Neoplastic lesions can also be detected but may be very difficult to evaluate because they can be mistaken for regenerating nodules. In such cases, highly sophisticated techniques, such as MRI with superparamagnetic iron oxide (ferumoxides), should be considered. Ferumoxides (negative contrast material) are phagocytosed by the reticuloendothelial cells of the normal liver, producing predominant T2 imaging on MRI. Therefore, a marked decrease in the signal in the normal liver parenchyma occurs, effectively permitting the identification of tumors.


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