Imaging findings of congestive hepatopathy

Michael Wells, Eric R. Fenstad, Joseph T. Poterucha, David M. Hough, Phillip M. Young, Philip A Araoz, Richard Lorne Ehman, Sudhakar K Venkatesh

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Congestive hepatopathy (CH) refers to hepatic abnormalities that result from passive hepatic venous congestion. Prolonged exposure to elevated hepatic venous pressure may lead to liver fibrosis and cirrhosis. Liver dysfunction and corresponding clinical signs and symptoms typically manifest late in the disease process. Recognition of CH at imaging is critical because advanced liver fibrosis may develop before the condition is suspected clinically. Characteristic findings of CH on conventional images include dilatation of the inferior vena cava and hepatic veins; retrograde hepatic venous opacification during the early bolus phase of intravenous contrast material injection; and a predominantly peripheral heterogeneous pattern of hepatic enhancement due to stagnant blood flow. Extensive fibrosis can be seen in chronic or severe cases. Hyperenhancing regenerative nodules that may retain hepatobiliary contrast agents are often present. Magnetic resonance (MR) elastography can show elevated liver stiffness and may be useful in evaluation of fibrosis in CH because it can be incorporated easily into routine cardiac MR imaging. Preliminary experience with MR elastography suggests its future use in initial evaluation of patients suspected of having CH, for monitoring of disease, and for assessment after therapy. To facilitate appropriate workup and treatment, radiologists should be familiar with findings suggestive of CH at radiography, ultrasonography, computed tomography, MR imaging, and MR elastography. In addition, knowledge of underlying pathophysiology, comparative histologic abnormalities, and extrahepatic manifestations is useful to avoid diagnostic pitfalls and suggest appropriate additional diagnostic testing.

Original languageEnglish (US)
Pages (from-to)1024-1037
Number of pages14
JournalRadiographics
Volume36
Issue number4
DOIs
StatePublished - Jul 1 2016

Fingerprint

Elasticity Imaging Techniques
Liver
Liver Cirrhosis
Contrast Media
Fibrosis
Magnetic Resonance Imaging
Venous Pressure
Hepatic Veins
Hyperemia
Inferior Vena Cava
Radiography
Signs and Symptoms
Liver Diseases
Dilatation
Ultrasonography
Tomography
Injections
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Wells, M., Fenstad, E. R., Poterucha, J. T., Hough, D. M., Young, P. M., Araoz, P. A., ... Venkatesh, S. K. (2016). Imaging findings of congestive hepatopathy. Radiographics, 36(4), 1024-1037. https://doi.org/10.1148/rg.2016150207

Imaging findings of congestive hepatopathy. / Wells, Michael; Fenstad, Eric R.; Poterucha, Joseph T.; Hough, David M.; Young, Phillip M.; Araoz, Philip A; Ehman, Richard Lorne; Venkatesh, Sudhakar K.

In: Radiographics, Vol. 36, No. 4, 01.07.2016, p. 1024-1037.

Research output: Contribution to journalArticle

Wells, M, Fenstad, ER, Poterucha, JT, Hough, DM, Young, PM, Araoz, PA, Ehman, RL & Venkatesh, SK 2016, 'Imaging findings of congestive hepatopathy', Radiographics, vol. 36, no. 4, pp. 1024-1037. https://doi.org/10.1148/rg.2016150207
Wells M, Fenstad ER, Poterucha JT, Hough DM, Young PM, Araoz PA et al. Imaging findings of congestive hepatopathy. Radiographics. 2016 Jul 1;36(4):1024-1037. https://doi.org/10.1148/rg.2016150207
Wells, Michael ; Fenstad, Eric R. ; Poterucha, Joseph T. ; Hough, David M. ; Young, Phillip M. ; Araoz, Philip A ; Ehman, Richard Lorne ; Venkatesh, Sudhakar K. / Imaging findings of congestive hepatopathy. In: Radiographics. 2016 ; Vol. 36, No. 4. pp. 1024-1037.
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