Hepatitis C CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

CT scan of HCV infection often shows hepatomegaly in the acute and early chronic HCV phase. It may, however, show normal findings. In contrast, findings on CT scan may be consistent with cirrhosis and portal hypertension, such as widening of the portal tract, ascites, and hepatosplenomegaly, or hepatic and extrahepatic masses suggestive of localized hepatocellular carcinoma and metastasis, respectively.

CT Imaging

Computed tomography (CT) scan findings of HCV are non-specific. In the majority of patients with acute HCV infection, CT scan will show normal findings or enlarged liver volume suggestive of hepatomegaly.

CT scan may also be helpful in the diagnosis of HCV-induced hepatic complications:

CT Scan Findings of Cirrhosis

Early Findings^[1]

CT scan is insensitive and unspecific in early cirrhosis. Early findings may include:

Hepatomegaly or shrunken liver
Widening of the porta hepatis
Enlarged interlobar fissure
Expansion of pericholecystic space
Portal hypertension
Visible left gastric, retrogastric, paraumbilical and other venous collaterals
Splenomegaly
Ascites
Intra and retroperitoneal edema
Small bowel and gallbladder wall thickening

Late Findings^[1]

Diffuse hepatic fatty infiltration
Heterogeneous aspect of the liver
Hypoattenuation of the liver parenchyma
Regenerative nodules observed in the monitory of patients
Nodular hepatic appearance

CT Scan Findings of Hepatocellular Carcinoma^[1]

The evaluation of hepatocellular carcinoma (HCC) due to viral hepatitis and subsequent cirrhosis requires a triple phase evaluation of the liver.^[1]

Mass of variable size
Homogeneous aspect (small masses) or heterogeneous aspect (large masses)
Presence of hypodense fibrous capsule
Intranodular vascular changes
Infiltration of adjacent structures
Mass lesions in distant organs suggestive of distant metastasis

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG (2013). “MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications”. HPB Surg. 2013: 129396. doi:10.1155/2013/129396. PMC 3748773. PMID 23986608.

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[pmid23986608-1] 1.0 ^1.1 ^1.2 ^1.3 Sangster GP, Previgliano CH, Nader M, Chwoschtschinsky E, Heldmann MG (2013). “MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications”. HPB Surg. 2013: 129396. doi:10.1155/2013/129396. PMC 3748773. PMID 23986608.

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