Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2022; 28(16): 1625-1640
Published online Apr 28, 2022. doi: 10.3748/wjg.v28.i16.1625
Noninvasive imaging of hepatic dysfunction: A state-of-the-art review
Ting Duan, Han-Yu Jiang, Wen-Wu Ling, Bin Song
Ting Duan, Han-Yu Jiang, Bin Song, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Wen-Wu Ling, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Duan T wrote the manuscript; Jiang HY contributed significantly to manuscript preparation and revision; Ling WW helped perform the analysis with constructive discussions; Jiang HY and Song B contributed to the conception of the study; all authors have read and approved the final manuscript.
Supported by Science and Technology Support Program of Sichuan Province, No. 2021YFS0021 and 2021YFS0141.
Conflict-of-interest statement: The authors have no conflict of interests related to this study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Song, MD, Chief Doctor, Professor, Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. anicesong@vip.sina.com
Received: March 18, 2021
Peer-review started: March 18, 2021
First decision: July 3, 2021
Revised: July 17, 2021
Accepted: March 27, 2022
Article in press: March 27, 2022
Published online: April 28, 2022
Abstract

Hepatic dysfunction represents a wide spectrum of pathological changes, which can be frequently found in hepatitis, cholestasis, metabolic diseases, and focal liver lesions. As hepatic dysfunction is often clinically silent until advanced stages, there remains an unmet need to identify affected patients at early stages to enable individualized intervention which can improve prognosis. Passive liver function tests include biochemical parameters and clinical grading systems (e.g., the Child-Pugh score and Model for End-Stage Liver Disease score). Despite widely used and readily available, these approaches provide indirect and limited information regarding hepatic function. Dynamic quantitative tests of liver function are based on clearance capacity tests such as the indocyanine green (ICG) clearance test. However, controversial results have been reported for the ICG clearance test in relation with clinical outcome and the accuracy is easily affected by various factors. Imaging techniques, including ultrasound, computed tomography, and magnetic resonance imaging, allow morphological and functional assessment of the entire hepatobiliary system, hence demonstrating great potential in evaluating hepatic dysfunction noninvasively. In this article, we provide a state-of-the-art summary of noninvasive imaging modalities for hepatic dysfunction assessment along the pathophysiological track, with special emphasis on the imaging modality comparison and selection for each clinical scenario.

Keywords: Hepatic dysfunction, Ultrasound, Computed tomography, Magnetic resonance imaging

Core Tip: Hepatic dysfunction can be frequently found in hepatitis, cholestasis, metabolic diseases, and focal liver lesions. It remains clinically silent until advanced stages, so there remains an unmet need to identify affected individuals at early stages. Imaging techniques, including ultrasound, computed tomography, and magnetic resonance imaging, allow morphological and functional assessment of the entire hepatobiliary system. In this article, we provide a state-of-the-art summary of noninvasive imaging modalities for assessing hepatic dysfunction in various clinical situations.