Visualization of Congestive Hepatopathy

Abstract

In various diseases of the heart, accompanied by the development of right heart failure with increased сentral venous pressure, congestive hepatopathy develops with subsequent fibrosis, necrosis of hepatocytes and liver cirrhosis. The main methods of diagnostic imaging of congestive hepatopathy are ultrasound, multiphasic computed tomography and magnetic resonance imaging. Ultrasound reveals hepatomegaly, ascites, increase in the diameter of inferior vena cava, hepatic veins. Doppler study reveals a change in the spectrum of blood flow in the hepatic veins: three phase smoothing of peaks in scale, reduced ante grade systolic peak component or complete reversion of the systolic component, the movement of the bloodstream “to-and-fro” in hepatic veins and inferior vena. In multiphase computed tomography and magnetic resonance imaging the extension of the inferior vena cava and hepatic veins is determined. In the arterial phase of enhancement reflux of contrast medium from the right atrium into the inferior vena cava and hepatic vein is marked. In the portal phase of contrast enhancement the heterogeneous, mottled, mosaic parenchymal pattern is determined, signs of interstitial lymph edema, peripheral patchy areas of weak or delayed contrast enhancement are revealed.