Main indications for computed tomography of the liver

One of the main methods for examining the liver is computed tomography (CT). This method is indicated for suspected various organ pathologies.

What is CT scan of the liver

Computed tomography (CT) is a special research method that can be used to obtain a three-dimensional image of an internal organ. During the examination, a person is irradiated with special electromagnetic rays in several planes, which makes it possible to obtain a three-dimensional image.

Often, a special contrast material is injected into the patient's body, which allows for a clearer image, which makes the study more accurate.

CT scans can be used to examine the liver. With its help, it is possible to identify liver pathologies even at an early stage of their development. Typically, a liver CT scan is prescribed by a doctor if a serious pathology is suspected or if other diagnostic methods do not provide a high-quality result.

A liver CT scan performs three tasks:

1. Detection of structural liver disorders;
2. Determining the cause of such violations;
3. Making a diagnosis and developing treatment methods.

Indications

Typically, a liver CT scan is prescribed if the following symptoms are present:

• Aching, pressing pain in the liver;
• Pain and feeling of heaviness in the right hip area;
• Nausea and bloating;
• Feeling of bitterness and metallic taste in the mouth;
• Change in color of stool and urine;
• Weakness and fatigue.

If the patient has most of the above symptoms, then a computed tomography scan will help confirm or refute one of the following diagnoses:

• Tumor or presence of metastases in the liver;
• Mechanical damage and/or inflammation;
• Damage to blood vessels and/or internal hemorrhage;
• Jaundice;
• Cirrhosis;
• Some types of dystrophy.

• In some cases, a CT scan is performed before a major operation, when it is very important for the doctor to know the appearance of the liver.

A computer examination is also carried out to assess the effectiveness of treatment. If the CT scan shows that the treatment was ineffective, the doctor may change the treatment method.

Contraindications

In general, CT is quite safe. However, it should be remembered that during the examination a person receives radiation exposure, so tomography should not be used too often so that the person does not develop radiation sickness. There are also other contraindications in the presence of which CT of the liver cannot be performed:

• Pregnancy (radiation exposure may affect fetal development);
• Age up to 14 years (rays can negatively affect the development of internal organs and bones);
• Excess body weight (most devices have a maximum permissible load level of 150 kg).

It should also be remembered that during a CT scan, contrast is usually injected into the body to improve the quality of the examination. However, it should be remembered that in some cases its use may be contraindicated:

• Serious kidney and liver diseases;
• Allergy to contrast agent components;
• Diabetes mellitus (in some cases).

Preparing for a CT scan of the liver

To get correct results, you need to properly prepare for a CT scan. Preparation begins 3-4 days before the examination. The patient must have blood and urine tested, since CT scans are almost always performed using contrast material, so it is important to rule out allergies.

You should refrain from eating and drinking 6 hours before the examination, since the CT scan must be performed on an empty stomach.

Before performing a CT scan, you also need to choose the right clothing without metal inserts or threads, since metal can “leave a shadow” on the volumetric image, which will make the examination results useless from a diagnostic point of view.

Progress of the procedure

Typically, liver tomography is done as follows:

• The person puts a special robe on the body without metal threads or inserts, and then lies down on the tomography table;
• A nurse administers a contrast agent to a patient using a syringe.
• After this, the doctor and nurse turn on the tomograph and leave the room. They watch the progress of the inspection from another room through glass.
• The doctor can use loudspeakers to communicate with the patient. Headphones should not be used for this as they may distort the transmission of the tomographic beams, rendering the examination results useless.
• When the patient has taken the desired position, the doctor turns on the examination mode, during which a special disk emitting electromagnetic rays begins to move in the tomography machine. To obtain an accurate image, the patient must remain completely still for 30-40 minutes. Optionally, the patient may be given sedatives if he cannot remain still for such a long period of time.
• All results are processed using a special computer program and saved to a hard drive for storage.

Contrast connection

When examining the liver, in almost all cases it is necessary to inject a contrast compound into the body. The fact is that the liver contains a large number of blood vessels, which without this substance will be practically invisible.

1. Only in very rare cases can an examination be carried out without the use of contrast (for example, in case of allergies), but the quality of such an examination will be quite low.

Benefits of CT

CT has many advantages:

• Three-dimensional images are very accurate and detailed, so CT can be used to diagnose diseases at both late and early stages of development.
• Using a three-dimensional image, you can establish the presence of a disease and understand the reasons that led to its appearance.
• The examination is completely painless, but the person will have to lie on the tomography table for about 30 minutes without moving.

Harmful CT scan of the liver

Computed tomography is a moderately safe method of examining the liver. During the scan, the body is irradiated quite mildly, which cannot lead to any negative side effects. However, to monitor treatment, the doctor may prescribe tomography quite often: in this case, radiation will begin to accumulate in the body.

• There is also a small chance that a person will become ill due to the introduction of contrast agents into the body, but preliminary tests can minimize the risk of allergic reactions.

Other diagnostic methods

CT is a fairly accurate and relatively safe method for examining the liver. The price of one session is approximately 4-7 thousand rubles. There are also several alternative methods that can be used to examine the liver. Among them:

• Ultrasound examination (ultrasound). This method is based on irradiating internal organs with ultrasound. It is usually used for preliminary diagnosis and detection of minor disorders, since ultrasound is easily scattered, making the test results quite inaccurate. Cost – less than 1 thousand rubles.
• Magnetic resonance imaging (MRI). This method is based on the phenomenon of magnetic atomic resonance. MRI allows you to get a good three-dimensional picture of internal organs. The main advantage of magnetic tomography is the fact that it does not use radiation rays, so the technique is safe for children and pregnant women. The cost of the study is about 10 thousand rubles.
• Positron emission tomography (PET). This technique is based on the annihilation effect of positrons, which are introduced into the body as a contrast agent, with electrons located in the body. This method is very accurate, but in Russia it is used extremely rarely due to its high cost (about 50 thousand rubles).

Liver CT is a very reliable examination method with which you can detect pathology and understand the causes of its occurrence. Before a liver CT scan, contrast material is injected into the body, which will improve the quality of the scan.

In some cases, CT may be contraindicated (pregnancy, early age, excess weight, etc.). If CT is contraindicated, MRI or PET can be used, but these examination methods are quite expensive.

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Liver CT: indications, contraindications, preparation for the study

The content of the article:

Dear readers, computed tomography (CT) of the liver and biliary tract is a radiological diagnostic method.

Since the study is carried out in most cases with contrast, the method is considered invasive and cannot be used often, like, for example, ultrasound.

Most often, CT scan of the liver with contrast is used for a general examination of all organs of the abdominal cavity in order to make an accurate diagnosis or when other diagnostic methods are uninformative.

Operating principle of CT

Computed tomography is based on the principle of absorption of X-rays by various tissues.

The method is similar to conventional X-ray diagnostics, but the diagnostic capabilities of computed tomography are broader; in addition, modern innovative devices and the ability to process the information received provide almost limitless opportunities for examining internal organs.

Until recently, specialists had to work on outdated 16-slice tomographs. And at the time of scanning, the person had to hold his breath for a short time. The radiation exposure was much higher than with modern and improved devices.

Today, outdated technology has been replaced by sophisticated multi-slice scanners, which are distinguished by high quality visualization of the organs and tissues being studied and minimal radiation exposure to the body.

During the examination, the X-ray tube rotates continuously, records data and processes information.

The multispiral unit rotates slowly at different angles, so the X-ray radiation used passes through all structures of the human body.

The rays are converted into electrical signals, and the diagnostician receives high-quality images showing the condition of internal organs, including bones and blood vessels.

The doctor enters the obtained data into a modern computer, where they can be stored for a long time in a systematized and convenient form. If desired, specialists use previously obtained information to conduct a comparative analysis of one or a series of images and evaluate the effectiveness of the drug therapy used.

During radiography, images of tissue appear on film. During a CT scan, X-ray radiation is supplied from different places, the device records the intensity of its absorption in specific areas of the study, after which the specialist receives pictures and interprets the images.

Indications for diagnosis

The liver has eight segments. During tomography, pathological changes in each of them can be detected. To diagnose the liver and its segments, CT is performed mainly with contrast enhancement.

Main indications for diagnosis:

• lack of information about other diagnostic methods;
• preparation for surgical interventions on the abdominal organs, including malignant neoplasms;
• a sharp deterioration in health, weight loss and suspicion of the appearance of metastases in the liver and biliary tract;
• abdominal trauma;
• assessment of the surgical or conservative treatment performed.

CT scan of the liver with contrast plays a special role in the diagnosis of oncopathologies of the abdominal organs. The drugs used make it possible to accurately visualize even small malignant tumors that have an extensive network of blood flow. Computed tomography is often used for abdominal injuries when a specialist suspects damage not only to soft tissue, but also to bone structures.

How to prepare for research

How to prepare for a CT scan of the liver, and is this special preparation necessary? To obtain the most reliable research results, it is necessary to exclude increased gas formation during diagnosis. Therefore, about a week before abdominal tomography, patients begin to follow a diet that excludes the consumption of foods and drinks that cause flatulence.

The following foods and drinks are prohibited before a liver CT scan:

• fresh bread, baked goods;
• carbonated drinks;
• cabbage and all legumes;
• canned food;
• smoked meats;
• lactic acid products.

As prescribed by your doctor, you can use special medications to ease digestive function and prevent gas formation. Diagnosis is carried out strictly on an empty stomach.

How is the examination carried out?

Since CT scans of the liver are performed quite quickly, which is especially important in case of injuries, when doctors do not have time to conduct ultrasound and MRI, the procedure is easily tolerated by patients. Contrast is injected through a vein shortly before the examination.

It is recommended to perform an allergy test first, so that unexpected reactions to the contrast agent used do not occur on the liver tomography.

Depending on the type of tomograph used, the diagnostician may ask the patient to hold their breath for a while.

We suggest watching a video of how the CT procedure is performed so that you can see it clearly.

Decoding the results

The results of a CT scan of the liver can be obtained immediately after the study or the next day. Based on defects in tissue filling with contrast agent and characteristic darkening, conclusions can be drawn about the condition of the organ and ducts. This is what a CT scan of the liver with contrast shows, including information about the condition of the blood vessels.

Normal on tomography:

• bile and hepatic ducts have a low density and, when contrast is used, are clearly distinguished from the parenchyma and vessels;
• the portal vein is visualized;
• the parenchyma has a homogeneous structure;
• The gallbladder may be invisible; when visualized, it is clearly distinguishable from other structures by its low density and rounded shape of the organ.

During a tomography, a specialist evaluates the size of the liver, its shape and structure. The dilation of the ducts is clearly visible. All neoplasms are clearly visible, including hemangiomas, which look like areas of low density.

MRI and CT scan of the liver - which is better?

Modern diagnostic methods make it possible to identify initial pathological changes in the functioning of human organs and systems. It is difficult to imagine the development of modern medicine without the use of CT and MRI.

These non-invasive diagnostic techniques are most often used to identify internal pathologies, including diseases of the abdominal cavity.

But, faced with a difficult choice between one and another examination method, many people do not understand what is better - CT or MRI of the liver and which method should be preferred in each specific case.

They are united by the word “tomography,” which means obtaining the thinnest layer-by-layer sections of organs and tissues, the image of which, after scanning, is sent to a personal computer and subjected to certain processing. But there is still a difference between CT and MRI, and it is quite significant.

How does CT differ from MRI?

To determine the differences between CT and MRI, it is necessary to understand the essence of these diagnostic methods. Computed tomography is based on examining tissue using x-rays and their ability to be absorbed differently by cells of different densities.

By and large, computed tomography is similar in principle to classical radiography, but the difference lies in the method of obtaining and processing data, as well as in the reduced radiation dose.

Conventional radiography is less informative than CT and is more dangerous in terms of the radiation dose received.

During tomography, the abdominal area is exposed to x-ray radiation, which, when passing through the patient's tissues with different densities, is absorbed differently by certain tissues.

In this case, layer-by-layer images of sections of the body appear.

High-quality computer equipment processes the received images and processes them, giving informative three-dimensional images that reflect the characteristics of the organ or body area being examined.

When using MRI, the doctor receives information about the condition of the liver and nearby tissues using a magnetic field, with the help of which hydrogen atoms in the human body actively change their position. The tomograph creates certain electromagnetic pulses that are processed into three-dimensional images.

The difference between MRI and computed tomography is obvious to specialists. The common man often simply does not know about it. CT has a certain radiation effect on tissue, so it is not used many times.

During a CT scan, you should also not move much, but the examination often takes only a few minutes.

Which is better - ultrasound or CT scan of the liver?

But which is better: ultrasound or CT scan of the liver? Ultrasound is often used due to its accessibility and lack of health risks. If we consider the issue in relation to pregnant women, then ultrasound is allowed without restrictions.

CT cannot be used at any stage of pregnancy, as the magnetic field can have a teratogenic effect on the unborn child. And in terms of the amount of information obtained, CT is significantly inferior to ultrasound research.

Benefits of using liver CT:

• high resolution: during diagnosis, the doctor receives layer-by-layer images, the thickness of which is less than 0.5 mm;
• reduction of study duration;
• high quality of received images;
• obtaining images of the heart and coronary vessels as quickly as possible (with the risk of developing circulatory disorders, even a minute of delay can cost the life of a sick person);
• the ability to obtain images in several dimensions at once;
• excellent visibility of scanned objects, high clarity of each image;
• minimal number of contraindications (pregnancy, breastfeeding, excess body weight);
• excellent informativeness of the method in cases of suspected blockage of coronary vessels;
• minimizing the risk of adverse reactions;
• affordable cost of research.

Contraindications

Computed tomography of the liver with contrast is not performed during pregnancy, since the drugs used cause radiation exposure to the body of the unborn child. The procedure is not used during breastfeeding.

The study is also contraindicated in case of individual intolerance to iodine, which is part of contrast agents.

Due to the increased load on the kidneys, CT with contrast cannot be used for serious disorders in the functioning of this organ and chronic pathologies of the thyroid gland.

Question answer

Is CT scan dangerous for health?

CT without contrast is safe for health, especially when performed in modern diagnostic rooms, which are illuminated by innovative tomographs. The contrast agent is potentially dangerous, but mainly for people with kidney failure and for women during pregnancy.

How long does a liver CT scan take?

The speed of liver CT scanning depends on the level of modernity of the tomograph and the size of the area being examined. On average, the procedure lasts 10-20 minutes. There is no pain associated with this.

Is CT scan possible for children?

For children, it is better to have a liver ultrasound or MRI. X-ray diagnostics is used mainly for abdominal injuries. Until the end of adolescence, human cells actively divide and grow, showing high susceptibility to X-rays. Therefore, it is not recommended to carry out X-ray diagnostics until children are 12-16 years old without special indications.

How often can a CT scan of the liver be performed?

No more than 2 times a year, since in one procedure a person receives 5-10 mSv of radiation, when the annual norm is 15 mSv. Therefore, the method is not used unless absolutely necessary. Ultrasound examinations are used for regular diagnosis. CT is more used for oncological pathologies and associated injuries and diseases of the abdominal organs.

The author of the article is a doctor of the highest category, Evgenia Nabrodova.

You may be interested in the following articles:
MRI of the liver.
What you need to know about the procedure MRI of the gallbladder and ducts
Ultrasound of the gallbladder and liver
Probing of the gallbladder

Source: https://gelpuz.ru/kt-pecheni

CT scan of the liver with or without contrast, what it shows, indications and contraindications

CT scan of the liver is one of the most informative ways to identify the organic causes of pathologies of the hepatobiliary system. Modern multislice tomographs provide layer-by-layer images of organs in just a few seconds, without causing any significant radiation exposure to the patient’s body.

Indications for computed tomography of the liver

In most cases, computed tomography is recommended after an ultrasound of the abdominal organs and laboratory tests of liver function. Identified deviations from the norm become the reason for a more extensive examination and clarification of the diagnosis.

The doctor may also refer the patient for a CT scan of the liver if he has the following complaints: nausea, vomiting, bitterness in the mouth, pain in the right hypochondrium. The reason for CT diagnostics may be syndromes such as jaundice or portal hypertension.

The main indications for liver CT are:

• the presence of jaundice (in order to clarify its nature: mechanical, parenchymal, suprahepatic);
• detection of neoplasms of the hepatobiliary system (cancer, hemangioma, etc.);
• diagnosis of cystic changes, including those of a parasitic nature;
• visualization of inflammatory pathologies (abscess, hepatitis);
• clarification of the nature and severity of changes in liver cirrhosis;
• elucidation of the causes of portal hypertension;
• determination of traumatic damage to the liver tissue and surrounding structures (hematoma, hemorrhage, bleeding).

Also, multislice CT of the liver is indicated at the stage of preoperative preparation. In this case, tomography allows one to obtain three-dimensional images of the hepatobiliary system. Based on the examination results, the surgeon draws up a surgical plan and carries out all manipulations as accurately as possible. This significantly reduces the risk of postoperative complications and shortens rehabilitation time.

A CT scan of the liver can also be prescribed to monitor the treatment, especially in the case of cancer pathology. The examination results reflect the dynamics of the process and allow further therapy to be adjusted.

Contraindications

An absolute contraindication for computed tomography is pregnancy. Despite the fact that MSCT has minimal radiation effects on the body, even small doses can cause developmental abnormalities in the fetus.

A limitation for tomography is that the patient’s weight is too high (from 130 to 150 kg). The exact figure should be clarified at a specific diagnostic center; it all depends on the model of the tomograph.

It is also not recommended to perform a CT scan on patients under eighteen years of age. Only the presence of compelling evidence can be the basis for sending a child to a CT scan.

What will a liver CT scan show?

During the study, it is possible to visualize liver tissue, stones and neoplasms located in the bile ducts. After administration of a contrast agent, vessels (arteries and veins) are clearly visualized on tomograms.

Due to the good contrast of the obtained images, this type of study allows us to identify any pathological changes in the liver tissue, both diffuse and focal. The resulting images clearly show foci with reduced density, cavitary formations, and the common bile duct. The doctor also evaluates the contours and size of the organ, the density of the liver tissue.

Based on the scan results, the following liver pathologies can be diagnosed:

• metastases from other organs;
• carcinoma (cancer);
• cysts, hemangiomas;
• fatty degeneration;
• cirrhosis;
• hematomas, damage to liver tissue;
• obstruction of the hepatic and bile ducts;
• gallstones;
• cholecystitis;
• liver vascular pathology;
• congenital pathologies.

A CT scan of the liver is especially important if an abdominal tumor is detected. The sections clearly show the contours of the neoplasm, the degree of its invasion into surrounding tissues, as well as metastasis to regional lymph nodes. Often, the results of the examination become decisive when choosing a treatment method and determine the prognosis for the patient.

Preparing for a CT scan of the liver

Preparation before a liver CT scan is not difficult: you need to arrive on an empty stomach or not eat four hours before the examination.

In case of expected contrast, you will need to undergo an examination in advance at the clinic at your place of residence. It is necessary to do a blood creatinine level test, which will reveal renal dysfunction.

In some medical centers, creatinine levels can also be determined on site using a special screening system.

When going for a computed tomography scan of the liver, you also need to have a referral and medical documentation regarding the pathology of the hepatobiliary system. This will help the doctor correctly interpret the data obtained. Additionally, you need to take care of comfortable clothes in which you will be comfortable lying still during the scan.

How is the examination carried out?

Before the scan, a clinic or center employee will briefly inform the patient about the features of the procedure. Allergies to iodine compounds, implanted metal devices, or suspected pregnancy should be reported to staff.

During the scan, the patient will be in a room with a tomograph, separated from the staff by an viewing window. Any sensations or unpleasant symptoms can be reported via the speakerphone built into the CT machine.

The procedure for taking images itself lasts relatively short, only a few minutes. However, at this time it will be necessary to maintain the most motionless body position; the information content of the examination directly depends on this.

Liver CT results can be obtained no earlier than in 30-40 minutes. During this time, the radiologist will review the received images, identify pathological changes, and analyze them.

Sometimes it may take more time to draw up a conclusion.

In this case, the patient will be warned in advance, he will be able to wait at the diagnostic center or go home and receive the results by email.

Liver CT scan with contrast

In clinical practice, when studying the liver, situations often arise when computed tomography with additional contrast is required. This is necessary for better visualization of focal changes in the liver tissue, as well as increasing the contrast of the vascular walls.

Liver CT with contrast is especially in demand when clarifying the nature of focal changes suspicious for a tumor process.

The administration of drugs with iodine makes it possible to make images of lesions clearer and with a high degree of probability to diagnose a malignant process.

To carry out the contrast procedure, clinics in St. Petersburg use special pharmaceuticals containing iodine. Modern non-ionic contrast agents are usually used (Ultravist, Yomeprol, etc.), which rarely provoke adverse reactions in patients.

A liver CT with contrast takes slightly longer than a native (non-contrast) study. In this case, a series of images is initially obtained without the introduction of contrast. After this, an iodine-containing drug is administered intravenously, using a special automatic injector.

Most patients do not present any complaints after its administration; occasionally, slight nausea, an unpleasant taste in the mouth, and a feeling of warmth in the body may be observed. Such phenomena last only a few minutes and do not require any medical attention.

If discomfort continues for a longer period of time, you should report it to the medical center staff.

The next stage of a CT scan with contrast of the liver is a repeat scan to obtain cross-sectional images of the organ being examined. As a result, such an examination can take from fifteen to twenty minutes. The entire scanning process is supervised by a doctor located in the next room.

After contrasting, you can lead your normal life. However, it is recommended to increase daily fluid intake, this will help remove the remaining pharmaceuticals from the body faster.

The administration of a contrast agent is contraindicated in the following conditions:

• allergic reactions to medications containing iodine;
• diseases of the thyroid gland;
• impaired filtration function of the kidneys.

It is also not recommended to perform liver CT with contrast in women who are breastfeeding. If it is still carried out, then you will need to interrupt feeding for one day and express milk.

Which is better: CT or MRI of the liver?

With regard to the liver, both methods provide the most accurate information about the pathological process. Which research method (CT, MRI) is more preferable is determined by the clinical situation and diagnostic purposes.

However, CT examination of the liver is more informative regarding fresh traumatic injuries; it better visualizes fresh bleeding or hematomas.

A CT scan is performed in a matter of seconds, and the diagnosis itself is slightly cheaper than an MRI.

Magnetic resonance imaging better visualizes soft tissues and is well suited for identifying inflammatory or tumor processes in them. The safety of the method makes it possible to use it repeatedly, including in children and late pregnant women.

Where to get diagnosed

The most informative and high-quality diagnostics will be on a multislice tomograph, which allows you to obtain at least sixteen slices per revolution of the scanner. This study takes place as quickly as possible, and the radiation dose received is equal to a regular x-ray.

Also an important point when choosing a clinic should be the qualifications of the specialist describing the liver images. Many years of experience and high qualifications of the doctor allow us to interpret the results as accurately as possible. In some centers you can also consult a doctor about the results and get answers to all your questions.

The cost of a liver CT scan may vary in different medical institutions in St. Petersburg, on average it ranges from 2,700 to 3,500 rubles. If contrast is performed, you will also need to pay extra for the pharmaceutical used. The cost depends on the newness of the equipment, the availability of promotions or discounts for preferential categories of patients.

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Computed tomography (CT) of the liver

Computed tomography of the liver is a non-invasive and painless procedure for studying this organ. Having received a tomographic report from a radiologist, the attending physician can assess the general condition, structural features, development and functioning of the liver. In a short period of scanning time, special X-ray equipment allows you to obtain high-precision images of the organ in different projections layer by layer. The entire operating principle of the tomograph is based on the use of the properties of X-rays, and this method of examining the body is considered safer than conventional radiography due to the lower level of radiation received by the patient in the process.

Tomographic scanning is the process of passing x-rays through the human body at certain intervals.

Specialized equipment - a tomograph ring - rotating around the patient, manages to take a series of images of the organ in sections with a step of 0.5 to 10 mm in one cycle lasting one second.

A series of images recorded by a tomograph enters a computer, where the corresponding program creates a three-dimensional, three-dimensional image of the liver and all its deep tissues.

To visualize in more detail the network of blood and lymphatic vessels, as well as neoplasms of any etiology, the method of computed tomography of the liver with contrast is used. The subject is injected with a dye that contains iodine.

The drug does not transmit x-rays, so it has a characteristic contrast appearance in the pictures.

Based on the characteristics of its distribution in the organ, the radiologist can judge the presence of narrowings or other pathologies in the liver vessels, the degree of spread of metastases, and the possible presence of neoplasms when they are at the initial stage of their development.

Self-medication has never been welcomed by doctors, and the same statement is true for such specific diagnostic methods as CT.

To do a CT scan of the liver, you must first consult with a therapist or specialist and receive an appropriate referral.

Tomography is practically not carried out as a preventive manipulation - ultrasound is sufficient for these purposes.

If the doctor has decided on the need to perform a computed tomography scan of the liver, then he sees an objective need:

• assess the condition of the organ and associated tissues and structures;
• identify tumors, lesions, injuries, bleeding, abscesses, and other types of liver disorders, if radiography or ultrasound cannot provide enough information to make a diagnosis and prescribe treatment;
• carry out preparatory measures for aspiration or biopsy of liver tissue;
• analyze the effectiveness of the treatment or surgical intervention performed;
• clarify the condition of the liver if previously obtained test results, for example, liver tests, are unsatisfactory.

Indications and contraindications for CT scan of the liver

An unpleasant feature of the development of liver diseases is the fact that it contains a small number of nerve endings, so a person cannot always feel that something abnormal is happening to the organ.

However, if the patient often complains of pain and heaviness in the liver area, bloating, metallic taste, nausea and bitterness in the mouth, such symptoms are an indication for an ultrasound, based on the results of which the doctor may prescribe a referral for a computed tomography scan.

Other indications for liver CT include:

• detection of organ enlargement for unknown reasons;
• the need to clarify the preliminary diagnosis, for example, cirrhosis or hepatitis;
• identification of pathological formations, the need to clarify their size and extent of distribution;
• suspicion of tumor diseases, the appearance of metastases;
• presence of disturbances in the functioning of liver vessels;
• conducting surgical interventions: surgeons prescribe CT scans before surgery, in preparation for it, and after it to assess its effectiveness;
• impaired blood flow and thrombosis in this part of the body;
• infectious and inflammatory processes, polycystic liver disease;
• chronic alcoholism, which, as is known, often provokes irreversible processes in the liver;
• previous abdominal injuries.

There are also situations where the potential risks of tomography are higher than the likely value of the data obtained in the process, or when, due to the nature of the human body, the information content of the study will be too low. In the presence of certain diseases and conditions, CT scanning can generally harm a person. Tomographic scanning of the liver is prohibited:

• for pregnant women and nursing mothers, due to the risk of exposure to the fetus;
• for children under 3 years of age, so as not to expose a very young body to x-rays;
• for diabetes mellitus, acute forms of bronchial asthma;
• in the presence of iodine intolerance, kidney or liver failure, if we are talking about computed tomography with contrast;
• in case of severe general condition of the patient, for example, if he is connected to life support devices;
• in diseases and pathologies associated with the manifestation of hyperkinesis: in such cases, the patient will not be able to ensure complete immobility during the scan, which is why the value of the resulting images will be almost zero.

For obese patients, liver CT remains questionable.

On the one hand, it is known that ultrasound is practically uninformative for them, since it poorly visualizes the organ due to the presence of a pronounced subcutaneous fat layer.

On the other hand, computer tomographs, in general, are simply not designed to weigh more than 140-180 kilograms. In such cases, the doctor decides at his own discretion how exactly the patient will be examined.

The results of a CT scan of the liver are pictures and images, analyzing and studying which, a radiologist can identify the following diffuse changes in the liver:

• various neoplasms: cancer, hemangioma, adenoma, other types of tumors;
• liver abscess is a purulent inflammation that affects the tissues of the organ and leads to the formation of a purulent cavity in it;
• signs of liver cysts, the appearance of which may be associated with trauma (hematomas, seromas and liver bruises) of other types of cysts;
• presence and extent of spread of metastases;
• echinococcosis is a parasitic lesion of an organ caused by the proliferation of a parasitic infection in it;
• signs of liver cirrhosis;
• signs of infectious or viral lesions, such as hepatitis.

In addition to pathologies and disorders, CT scan of the liver also shows the functional characteristics of the organ, as well as the changes found in it - tissue density, size, location of tumors or metastases, their depth.

Do I need to prepare for a CT scan of the liver?

Preparation for computed tomography of the liver does not have any features that distinguish it from other types of tomography. It is recommended to conduct the examination on an empty stomach, so you should not eat 2-4 hours before the examination. A couple of days before the examination, you should reduce the consumption of foods that contribute to increased gas formation, and completely eliminate alcohol intake.

It is imperative to inform the doctor about all medications used by the patient. It may be necessary to take a break from taking them for a while before the study.

Patients undergoing a contrast-enhanced CT scan will need to have their creatinine tested. In some cases, if the patient cannot give an accurate answer about whether he is allergic to iodine or other substances, the doctor may additionally prescribe appropriate tests - allergy tests.

For 15 minutes (in rare cases - up to half an hour) the patient is under the targeted influence of x-rays. All that is required of him is not to move, and strictly follow the doctor’s instructions when he asks him to hold his breath.

If the procedure involves the introduction of a contrast agent, then after the first scan the table with the patient is rolled out of the scanner, a catheter with the substance is placed in the cubital vein, and the patient is sent back to the tomograph for scanning. In this case, the contrast is introduced by the x-ray technician before the second scan begins.

During the process, the device buzzes, crackles, and makes a characteristic noise. For patients for whom this fact causes discomfort, the x-ray technician has earplugs or headphones prepared.

The radiologist and x-ray technician are in the next room - from there they monitor the progress of the procedure and can communicate with the patient. If a person feels a sharp malaise, pain, or deterioration of health during the process, he immediately reports this to the doctor.

A series of images taken during the examination are recorded in computer media and processed by a special program that produces ready-made layer-by-layer images.

Tomographic scanning of the liver occurs in segments closely related to the duct system, of which there are five in the liver. This technique greatly simplifies the examination, further reading of the results and the radiologist’s conclusions.

The development of this device at one time became a real breakthrough, and CT is still considered a way to obtain the clearest and most informative images of human internal organs and their deep structures. A qualified radiologist can not only detect the presence of diseases and pathologies in images, but also outline the range of reasons that led to their appearance.

In some emergency cases, the fact that the examination itself takes 15 minutes also plays an important role. If the patient has acute injuries, bleeding and damage, every second of delay becomes fatal for him, so the ability to obtain examination results in such a short period of time is highly valued.

Computed tomography is undoubtedly safer than radiography, as it exposes the patient to significantly less radiation.

The diagnosis of liver tumors has made great progress with the advent of computed tomography.

In cases where tests, ultrasound and radiography cannot provide the doctor with complete and accurate information about the presence, extent and nature of liver damage, prescribing a CT scan is a real way out.

Computer diagnostics using the properties of X-rays makes it possible to identify pathological processes in the liver even at the early stages of their development, and with minimally noticeable manifestations.

Tedeeva Madina Elkanovna

Specialty: therapist, radiologist.

Total experience: 20 years.

Place of work: SL Medical Group LLC, Maykop.

Education: 1990-1996, North Ossetian State Medical Academy.

Training:

1. In 2016, at the Russian Medical Academy of Postgraduate Education, she underwent advanced training in the additional professional program “Therapy” and was admitted to carry out medical or pharmaceutical activities in the specialty of therapy.

2. In 2017, by the decision of the examination commission at the private institution of additional professional education “Institute for Advanced Training of Medical Personnel”, she was admitted to carry out medical or pharmaceutical activities in the specialty of radiology.

Work experience: therapist – 18 years, radiologist – 2 years.

Source: https://FoodandHealth.ru/diagnostika/kt-pecheni/