Computed Tomography

  • Maxime Ronot
  • Romain Pommier
  • Paul Calame
  • Yvonne Purcell
  • Valérie Vilgrain
Chapter

Abstract

Cirrhosis is a heterogeneous and dynamic condition, associated with the progressive deposition of hepatic fibrosis that leads to increased vascular resistance at the level of the hepatic sinusoids, and to portal hypertension. Cirrhosis accounts for 90% of the causes of portal hypertension (PHT) in adults. Increased portal pressure is the main factor determining the clinical course of cirrhosis. An accurate estimation of the severity of fibrosis and PHT is essential to evaluate the disease state and prognosis, and is often the first step towards the optimization of treatment. Liver biopsy and invasive measurement of hepatic venous pressure gradient (HVPG) are the gold standard techniques for the estimation of hepatic fibrosis and PHT, respectively. However, both are invasive and, as such, cannot be used repeatedly in clinical practice. As a consequence, the need for non-invasive diagnosis tests for cirrhosis and PHT is major. Computed Tomography (CT) is a fast, standardized, and cheap cross-sectional imaging technique based on 3D X-ray technology that provides an anatomical exploration of organs. In the field of hepatology it is routinely used for the exploration of patients with chronic liver disease and portal hypertension, but also for the characterization of focal liver lesions. This chapter aims to review the role of CT in the diagnosis, grading, and prognosis of hepatic fibrosis and portal hypertension.

Keywords

Cirrhosis Portal hypertension Computed tomography Dual-energy CT Perfusion CT 

Abbreviations

CT

Computed tomography

DE-CT

Dual-energy computed tomography

fEES

Fractional extravascular extracellular space

HCC

Hepatocellular carcinoma

HH

Hepatic hydrothorax

HPS

Hepatopulmonary syndrome

HVPG

Hepatic venous pressure gradient

LSN

Liver surface nodularity

MRI

Magnetic resonance imaging

PCT

Perfusion tomography perfusion

PHT

Portal hypertension

TIPS

Transjugular intrahepatic portosystemic shunt

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maxime Ronot
    • 1
    • 2
    • 3
  • Romain Pommier
    • 1
    • 2
  • Paul Calame
    • 1
    • 2
  • Yvonne Purcell
    • 1
  • Valérie Vilgrain
    • 1
    • 2
    • 3
  1. 1.Department of RadiologyHôpitaux Universitaires Paris Nord Val de Seine, BeaujonClichyFrance
  2. 2.University Paris DiderotSorbonne Paris CitéParisFrance
  3. 3.INSERM U1149Centre de Recherche Biomédicale Bichat-Beaujon, CRB3ParisFrance

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