Latest imaging tests can provide good diagnostic results without risks of complications.
Liver disease is generally examined with ultrasonography instead of
plain abdominal radiography. Ultrasonography can determine whether the hepatic parenchyma is diffusely abnormal, such as in a patient with acute viral hepatitis. Ultrasonography can identify in nonalcoholic fatty liver disease with bright hepatic echo texture and cirrhosis with coarsened echo texture.
Image of liver captured by ultrasonography
Besides ascites, ultrasonography can show other signs of portal hypertension, such as splenomegaly or intra-abdominal varices. Patients with obstructive jaundice can be initially evaluated with ultrasonography. Ultrasonography can confirm dilated bile ducts of patients with biliary obstruction and identify the cause, such as a pancreatic tumor or gallstones in the common bile duct. Doppler flow study can examine blood flow through the portal and hepatic vessels. Ultrasound study can distinguish hepatic tumor from hepatic cyst.
CT and MRI
Computed tomography (CT) and magnetic resonance imaging (MRI) can show greater details of hepatic vasculature and hepatic tumor. Since MRI can also obtain a very detailed cholangiogram, many patients with suspected bile duct obstruction do not need to have invasive endoscopic retrograde cholangiopancreatography.
Liver biopsy is a definitively assessment test examined for the severity of hepatitis and the extent of fibrosis in diffuse hepatocellular disease. Liver biopsy can also confirm diagnostic results of noninvasive tests for diseases including autoimmune hepatitis, or diagnose diseases including drug hepatotoxicity. Since biopsy is likely to have complications, such as intra-abdominal bleeding, it is recommended in limited situations such as when a non-invasive test has not provided a definitively diagnostic result or prognosis.