Sequential imaging of the progress of acute alcoholic hepatitis with ultrasound and isotopes

It has been established that in alcoholic liver disease the 99Tcm sulphur-colloid gamma images of the liver correspond to the severity of the disease (Geslein et al., 1976). Changes in the size of liver and spleen, in the uptake pattern and in the shift of activity to spleen and bone marrow, can be documented by sequential isotope studies. It has been recognized for some years that in patients with cirrhosis of the liver, ultrasound examination may show high amplitude echoes, giving rise to a brightly reflective liver echo pattern. The significance of the ultrasound finding of a bright liver echo pattern has been shown to be high (Joseph et al., 1979). However, the finding appears to be rather non-specific in relation to the detailed pathology found at liver biopsy, being seen in cirrhosis, fatty infiltration and also in severe hepatitis. Not all patients with cirrhosis will show a bright liver echo pattern. Recently Dewbury and Clark (1979) have shown that 35% of patients with cirrhosis have a normal liver echo pattern at ultrasound examination. This percentage is lower in patients with micronodular cirrhosis.