Michael Leigh Wells MD, Presenter: Nothing to Disclose

Joseph Poterucha, Abstract Co-Author: Nothing to Disclose

Eric Fenstad, Abstract Co-Author: Nothing to Disclose

Sudhakar Kundapur Venkatesh MD, FRCR, Abstract Co-Author: Nothing to Disclose

Phillip Matthew Young MD, Abstract Co-Author: Nothing to Disclose

Philip A. Araoz MD, Abstract Co-Author: Nothing to Disclose

David Maitland Hough MD, Abstract Co-Author: Nothing to Disclose

Richard L. Ehman MD, Abstract Co-Author: CEO, Resoundant, Inc

Understand pathophysiology of congestive hepatopathy (CH). Imaging appearances of CH Role of MR Elastography  

Background: CH refers to hepatic manifestations resulting from passive hepatic congestion due to cardiac causes. Prolonged CH may lead to liver fibrosis/cirrhosis. Significant liver fibrosis may develop before detection as liver dysfunction typically manifests late. Constrictive pericarditis in particular can result in rapid development of cirrhosis. Pathophysiology: CH results from increase in central venous pressure transmitted via inferior vena cava (IVC) and hepatic veins (HV) to sinusoids. Raised sinusoidal pressure, decreased hepatic venous blood flow and hypoxia results in degeneration of hepatocytes, particularly around central veins. Imaging findings: Dilated IVC and HVs; retrograde HV opacification at the early bolus phase; a diffusely mottled pattern of hepatic enhancement (nutmeg liver) and areas of patchy enhancement due to stagnant blood flow. Frequently extensive fibrosis with multiple regenerative nodules may be found. Magnetic resonance elastography (MRE) can demonstrate elevated liver stiffness secondary to liver fibrosis and may be useful in evaluation of fibrosis in CH. MRE can be easily performed after a cardiac MRI study.Preliminary experience with MRE in CH will be illustrated.  

http://abstract.rsna.org/uploads/2014/14001241/14001241_abjz.pdf

Wells, M, Poterucha, J, Fenstad, E, Venkatesh, S, Young, P, Araoz, P, Hough, D, Ehman, R, Congestive Hepatopathy: Imaging Findings.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001241.html