Hepatomegaly

Preliminary Diagnosis: Hepatomegaly

I. What imaging technique is first-line for this diagnosis

• Ultrasound with measurement of the liver in the longitudinal plane.

II. Describe the advantages and disadvantages of this technique for diagnosis of hepatomegaly.

Advantages

• Quick, inexpensive

• No ionizing radiation

Disadvantages

• Operator dependent to obtain accurate longitudinal measurements of the liver

III. What are the contraindications for the first-line imaging technique?

• No significant contraindications

  Related Content

IV. What alternative imaging techniques are available?

• Plain Films

• CT

• MRI

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of hepatomegaly.

Plain film (radiographs)

Advantages

• Quick, inexpensive

• Minimal radiation exposure

• Can assess for displacement of right kidney and hepatic flexure

Disadvantages

• Limited in patients with large body habitus or significant intraluminal contrast or gas-filled prominent loops of bowel overlying the right upper quadrant

• Plain films are not very specific and lack very clear anatomic detail

CT

Advantages

• Can obtain imaging very quickly

• Able to visualize the liver in multiple planes; may be able to use 3-D reconstruction

• Very specific and helpful in identifying any possible lesions/masses/nodules within the liver if intravenous contrast administered

• Although greater exposure to radiation, triple phase CT is often very informative with all liver lesions as it provides comprehensive enhancement characteristic analysis

Disadvantages

• Greater exposure to ionizing radiation than plain film radiography

• More expensive than obtaining a radiograph, ultrasound, or palpation of the liver

MRI

Advantages

• Able to better visualize the liver in multiple planes

• Very specific and helpful to identify any possible lesions/masses/nodules within the liver especially if intravenous contrast is administered

Disadvantages

• More expensive than obtaining a CT, radiograph, ultrasound, or palpation of the liver

• Requires significant patient cooperation during acquisition of the images to minimize artifact

VI. What are the contraindications for the alternative imaging techniques?

Plain films (radiographs)

• No significant contraindications

• Relative contraindication in pregnancy

CT

Pregnancy

MRI

• Absolute contraindication in patients with non-MR compatible hardware

Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.