Congestive hepatopathy: the role of the radiologist in the diagnosis

Özet

The liver has a complex vascularization and is subjected to a high metabolic demand, making itvulnerable to hemodynamic changes. As a result, several pathologies can develop, one of whichis congestive hepatopathy. This disease occurs secondary to various cardiovascular conditionsthat generate a persistent passive venous congestion in the liver, which in the long term canculminate in fibrosis and cirrhosis, which in turn increases the risk of developing hepatocellularcarcinoma. In order to avoid this outcome, early diagnosis is crucial; however, both the clinicalpresentation and laboratory tests are unspecific, and they are only altered in advanced stages ofthe disease. One form of early detection is through imaging findings, there being various usefulmodalities such as Doppler ultrasonography (US), computed tomography, and magnetic resonance imaging. The purpose of this article is to detail the imaging findings of congestive hepatopathy in the different available modalities, with special emphasis on Doppler US, highlightingthe role of the radiologist in the suspicion of this disease. We summarize the pathophysiologicmechanisms of congestive hepatopathy, clinical findings, and provide description of its maindifferential diagnoses.