Diagnosis of Cirrhosis: Imaging

Liver biopsy is an essential tool for the hepatologist in the diagnosis and management of patients with cirrhosis. However, a pathological diagnosis is not always necessary to diagnose cirrhosis. Often clinical assessment with a complete history and physical examination, analysis of patterns of abnormalities in serum markers, and examination of common diagnostic radiologic modalities in totality allow for the diagnosis of cirrhosis. Abdominal imaging, namely computed tomography, ultrasound (US) with Doppler evaluation, and magnetic resonance imaging (MRI), serves as a useful crutch in this regard for both diagnostic and prognostic purposes. This chapter reviews the strengths and weaknesses of each of the modalities as it pertains to diagnosis of cirrhosis. Further, novel applications of elastography (both US and MRI-based) as another noninvasive tool to diagnose cirrhosis are discussed.