GI Radiology > Liver > Diffuse > Hepatitis

Diffuse Hepatic Disease

Hepatitis: Acute vs. Chronic

1. Pathogenesis:
  • Acute hepatitis of any origin causes the hepatocytes to become edematous. Clinical correlation is more helpful in diagnosis of hepatitis while role of liver imaging is limited.
  • Hepatitis can cause enlarged liver without focal disease.
  • Hepatitis A is transmitted fecal-orally. Clinical manifestations are usually fatigue, weakness, vague abdominal pain, hepatomegaly (85%), and splenomegaly (15%).
  • Hepatitis B is typically acquired through I.V. drug use, sex, or blood transfusion. 5% will become chronic. Less than 1% will be fulminant. Hep B infection does increase risk for cirrhosis, portal HTN, HCC.
  • Hepatitis C is mostly acquired via transfusion, sex, or I.V. drug use.
  1. Radiographic findings:
  • There are no definite abnormalities on imaging in both acute and chronic hepatitis.
  • U/S: In acute, either entirely normal or may have a "starry sky" appearance (decreased echogenicity of the parenchyma with prominence of the portal venous system). In chronic, there may be a coarsely echogenic parenchymal pattern.
  • CT or MRI: not used to evaluate acute hepatitis.

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