Acute Hepatitis





KEY FACTS


Terminology





  • Inflammation of liver due to viral infection or toxic agents



Imaging





  • Acute: Enlarged liver



  • Chronic: Decrease in liver size



  • Grayscale ultrasound




    • Acute hepatitis: Hepatomegaly and diffusely hypoechoic parenchyma (variably seen)



    • Steatohepatitis and acute alcoholic hepatitis: Hepatomegaly and diffusely hyperechoic liver parenchyma



    • Thickening of gallbladder wall




      • Most pronounced in acute hepatitis A




    • Starry-sky appearance: Portal triads appear markedly echogenic due to periportal edema against background hypoechoic liver (variably seen)




      • May be related to periportal edema





  • Pulsed Doppler ultrasound




    • Elevated hepatic arterial velocity




Top Differential Diagnoses





  • Infiltrative hepatocellular carcinoma



  • Lymphoma



  • Steatosis (fatty liver)



Pathology





  • Viral hepatitis: Caused by 1 of 5 viral agents




    • Hepatitis A (HAV), B (HBV), C (HCV), D (HDV), E (HEV) viruses




  • Alcohol abuse



  • Autoimmune reactions



  • Metabolic disturbances



  • Toxic or drug-induced injury



  • Exposure to environmental agents



  • Radiation therapy



Scanning Tips





  • Check for tender liver, which may be related to inflammation from acute hepatitis



  • Check gain settings, which can affect appearance of liver and may mimic hepatitis or steatosis




Nov 9, 2024 | Posted by in ULTRASONOGRAPHY | Comments Off on Acute Hepatitis

Full access? Get Clinical Tree

Get Clinical Tree app for offline access