Table 2 Classification of hepatobiliary disorders according to clinical and imaging classifications
From: Liver imaging and pregnancy: what to expect when your patient is expecting
Condition | Trimester | Symptoms | Imaging Findings | Main Role of Imaging | Imaging technique |
|---|---|---|---|---|---|
ICP | II-III | Pruritus, increased serum bile acids, jaundice uncommon | Gallstones (without intrahepatic biliary dilatation) and/or intrahepatic lithiasis | Differential diagnosis; detection of gallstones and complications | US +++ MRCP ++ |
AFLP | II - III | Recent nausea and/or vomiting, polydipsia, jaundice, abdominal pain | Fatty changes, ascites | Diagnosis, assessment of complications | US ++ CT + (+++ if complications) MRI +++ |
Pre-eclampsia/ Eclampsia | II-III | Arterial hypertension, edema | Portal vein thrombosis, hemorrhage | Assess liver involvement as soon as possible | US ++ CT ++ |
HELLP Syndrome | III/post-partum | Frequent arterial hypertension, right upper quadrant pain, fever (associated with liver infarct), edema, hypovolemic shock | Infarct, hemorrhage, subcapsular hematoma, liver rupture | Diagnosis and assess complications as soon as possible | US ++ (bedside patient) CT +++ (if unstable) |
Budd-Chiari Syndrome | II - III | Abdominal pain, ascites, hepatomegaly, liver failure | Hepatic venous occlusion, regenerative nodules, hepatomegaly, portal hypertension | Detect venous thrombosis, surveillance | US +++ CEUS ++ CT + MRI + |
HHT | III/post-partum | Pain, liver failure, bleeding | Liver infarction, aneurysm rupture | Surveillance and diagnosis of complications | US ++ CT + (+++ if complications) MRI + |
Cirrhosis | Any | Decompensation, worsening portal hypertension, variceal bleeding | Ascites, focal liver lesions assessment, portal hypertension | Surveillance, assess complications, treatments (TIPS) | US +++ CEUS ++ (if lesions) MRI ++ (if lesions) |
Focal Hepatic Masses | Any | Abdominal tension or pain / Asymptomatic | Growth +/- bleeding and liver rupture | Detect and characterize | US ++ CEUS ++ MRI ++ CT + (only if cancer) |
Cholelithiasis | Any | Right upper quadrant pain, nausea | Gallstones, pancreatitis, ductal dilatation | Diagnosis | US +++ MRI ++ |
Hepatitis | Any | Nausea, inconstant jaundice, liver dysfunction | Hepatomegaly, gallbladder wall thickening, diffuse hepatic hypoechogenicity // small hypoechoic lesions | Differential diagnosis and confirmation of diagnosis | US +++ CT + MRI ++ |
Abscesses | Any | Fever, nausea, pain | Avascular, thick-walled fluid collection, perfusion disorders | Diagnosis and guidance of treatment | US +++ CT + MRI ++ |
Liver transplantation | 2nd half of pregnancy //post-partum | Pre-eclampsia and HELLP syndrome | Infarct, hemorrhage, hematoma, liver rupture | Assess complications as soon as possible | US +++ CT (when complications) +++ |