الفهرس 
GROSS LIVER ANATOMYOnly 14 pages are availabe for public view
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Abstract
Chronic liver disease and cirrhosis remain a major public health problem worldwide. While the majority of complications from chronic liver disease result from progressive hepatic fibrosis, the available diagnostic tests used in clinical practice are not sensitive or specific enough to detect occult liver injury at early or intermediate stages.
The quantification of hepatic fibrosis is of major importance during chronic diseases of the liver, among which the therapeutic indications and the diagnosis depend on it widely. The histological examination, obtained by biopsy, was for a long time considered the preferred reference examination.
While liver biopsy can stage the extent of fibrosis at diagnosis, its utility as a tool for longitudinal monitoring will be limited at the population level.
Our growing understanding of liver injury and fibrogenesis is being used to develop non-invasive tests for fibrosis that are accurate and replace liver biopsy. The current serum tests are a start and may have utility in identifying patients with minimal fibrosis who do not need a liver biopsy. However, as with many new diagnostic technologies, such tests are being adopted and marketed while the evidence of their general utility in various practice settings remains incomplete.
To date, a number of methods including serum marker panels and ultrasound-based transient elastography have been proposed for the non-invasive identification of hepatic fibrosis. Novel techniques including magnetic resonance (MR) spectroscopy, diffusion weighted MR, and MR Elastography have also emerged for detecting fibrosis.
Using ultrasound, cirrhosis is suggested by liver surface nodularity and portal vein mean flow velocity. The caudate lobe is enlarged relative to the right lobe. However, ultrasound is not reliable for the diagnosis of cirrhosis. Regenerating nodules may be shown as focal lesions.
CT scan is cost effective for the diagnosis of cirrhosis and its complications. Liver size can be assessed and the irregular nodular surface seen. Benign regenerative nodules are not visualized by CT. Fatty change; increased density due to iron and a space-occupying lesion can be recognized.