Radiation hepatitis manifests clinically as jaundice and hepatomegaly several weeks after radiation therapy. The presumed underlying mechanisms are Kupffer cell and vascular endothelial damage.
Imaging identifies the boundary between normal and irradiated liver to be sharply defined and corresponding to the radiation port, a finding not seen with overlapping ports. Once regeneration starts, the sharp boundary becomes less well defined. Radiation hepatitis is iso- to hypodense relative to normal liver on CT Vessels in the involved region appear normal. Postcontrast, CT Abdoment with contrast appearance is inconsistent and ranges from hypo tohyperdense. The involved liver parenchyma is mostly hypoechoic on US.
Radiation hepatitis is hypointense on T1-and hyperintense on T2-weighted MR images. Anecdotal reports describe iron colloidenhanced MRI showing decreased uptake in acute radiation-induced hepatic injury. Eventually abnormalities either resolve or the involved liver segments atrophy.
tis picture predominates. Whether this condition is called hepatitis, cholestasis, or cholestatic hepatitis is a moot point. Other cholestatic conditions, including neonatal hepatitis, are discussed.
Cholestasis is a manifestation of paraneoplastic syndrome in patients with malignant lymphoproliferative diseases. Extrahepatic Hodgkin’s disease, renal cell carcinoma, and other cancers have been associated with cholestasis. Acute vanishing bile duct syndrome is usually associated with drug or toxin use and is a rare cause of cholestasis. It develops mostly in adults.
Rarely, cholestasis progresses to cirrhosis. Idiopathic benign recurrent cholestasis is a rare disorder diagnosed mostly by exclusion. Osteoporosis and osteomalacia develop in patients with chronic liver disease, especially those with chronic cholestasis.
This under CT Abdoment with contrast for radiation hepatitis, please see:
CT Abdoment with contrast Radiation hepatitis after prior radiation therapy for breast carcinoma. CT outlines a focal, sharply defined anterolateral defect (arrow). (Courtesy of Patrick Fultz, M.D., University of