CT of the liver

Author: Mikael Häggström ^{[notes 1]}

Planning

Choice of modality

For the liver, the initial imaging of choice is generally as follows:

• Ultrasonography of the liver for suspected cirrhosis and/or portal hypertension.^[1]
• CT of the liver, often as part of a general abdominal CT, is generally the investigation of choice to look for metastases of recently diagnosed cancers in the abdomen.^[2]
• MRI of the liver is indicated in hypervascular lesions that may represent a focal nodular hyperplasia (FNH).^[3]

Analysis

Focal changes: Scroll through the entire parenchyma, preferably in segments, such as right third, middle third and left third, in order to have greater focus on small details.

Potential findings

• Hypoattenuating lesions

• If less than 10 mm in diameter they are generally difficult to characterize adequately.^[4] Even in a patient with known malignancy, and with multiple lesions of this size, their presence does not increase the risk of developing liver metastasis, and should practically be regarded as benign.^[5]
• Large simple cysts (>4 cm) may be followed up ensure stability.^[6]

Notes

References