Cirrhosis other imaging findings

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Sudarshana Datta, MD [3]


Tc-99m labeled sulfur may be used in nuclear imaging to provide some indication of hepatic function in cirrhotic patients. In candidates for liver transplant, CTA is used to asses the drainage of the liver. All patients with cirrhosis must undergo a diagnostic endoscopy for the evaluation of varices. Gastric endoscopy is an option if gastric varices are suspected, and endoscopic ultrasound may also help in the visualization of varices. ERCP is performed if a biliary pathology such as primary sclerosing cholangitis is suspected as the underlying cause of cirrhosis.

Other Imaging Findings

Nuclear Imaging



Esophageal varices-By Samir, via Wikimedia Commons[8]
Gastric varices-By Jeremias (Own work), via Wikimedia Commons[9]

Endoscopic Ultrasound (EUS)


Three dimensional portal venography

Venography Source:Open-i[16]
Venography-Case courtesy of Dr Omar Bashir, via[17]


  1. Nishikawa H, Osaki Y (2015). "Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis". Mediators Inflamm. 2015: 872152. doi:10.1155/2015/872152. PMC 4606163. PMID 26494949.
  2. McLaren MI, Fleming JS, Walmsley BH, Ackery DM, Taylor I, Karran SJ (1985). "Dynamic liver scanning in cirrhosis". Br J Surg. 72 (5): 394–6. PMID 3995244.
  3. Kim YS, Cho SW, Lee KJ; et al. "Tc-99m MIBI SPECT is useful for noninvasively predicting the presence of MDR1 gene-encoded P-glycoprotein in patients with hepatocellular carcinoma". Clin Nucl Med. 24 (11): 874–9. PMID 10551471.
  4. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W (2007). "Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis". Hepatology (Baltimore, Md.). 46 (3): 922–38. doi:10.1002/hep.21907. PMID 17879356. Retrieved 2012-09-06.
  5. Zardi EM, Di Matteo FM, Pacella CM, Sanyal AJ (2014). "Invasive and non-invasive techniques for detecting portal hypertension and predicting variceal bleeding in cirrhosis: a review". Ann. Med. 46 (1): 8–17. doi:10.3109/07853890.2013.857831. PMC 4904298. PMID 24328372.
  6. Abby Philips C, Sahney A (2016). "Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place". Gastroenterol Rep (Oxf). 4 (3): 186–95. doi:10.1093/gastro/gow018. PMC 4976684. PMID 27324725.
  7. Thakeb F, Salem SA, Abdallah M, el Batanouny M (1994). "Endoscopic diagnosis of gastric varices". Endoscopy. 26 (3): 287–91. doi:10.1055/s-2007-1008969. PMID 8076547.
  8. <"">via Wikimedia Commons
  9. <"">via Wikimedia Commons
  10. Lebrec D, De Fleury P, Rueff B, Nahum H, Benhamou JP (1980). "Portal hypertension, size of esophageal varices, and risk of gastrointestinal bleeding in alcoholic cirrhosis". Gastroenterology. 79 (6): 1139–44. PMID 6969201. |access-date= requires |url= (help)
  11. Christensen E, Fauerholdt L, Schlichting P, Juhl E, Poulsen H, Tygstrup N (1981). "Aspects of the natural history of gastrointestinal bleeding in cirrhosis and the effect of prednisone". Gastroenterology. 81 (5): 944–52. PMID 7026343. |access-date= requires |url= (help)
  12. "Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study". The New England Journal of Medicine. 319 (15): 983–9. 1988. doi:10.1056/NEJM198810133191505. PMID 3262200. Retrieved 2012-09-07.
  13. Yasuda K, Cho E, Nakajima M, Kawai K (1990). "Diagnosis of submucosal lesions of the upper gastrointestinal tract by endoscopic ultrasonography". Gastrointestinal Endoscopy. 36 (2 Suppl): S17–20. PMID 2184080. |access-date= requires |url= (help)
  14. Agarwal A, Jain M (2008). "Multidetector CT portal venography in evaluation of portosystemic collateral vessels". J Med Imaging Radiat Oncol. 52 (1): 4–9. doi:10.1111/j.1440-1673.2007.01903.x. PMID 18373819.
  15. Kang HK, Jeong YY, Choi JH, Choi S, Chung TW, Seo JJ; et al. (2002). "Three-dimensional multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis". Radiographics. 22 (5): 1053–61. doi:10.1148/radiographics.22.5.g02se011053. PMID 12235335.
  16. "(A) Angiographic portography revealed portal vein, coro | Open-i".
  17. From the case <"">rID: 16761

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