Acute viral hepatitis is diagnosed primarily by clinical or serological examination; cross-sectional imaging is not normally part of the primary diagnostic approach. Typical MR findings in acute viral hepatitis are hepatomegaly combined with edema of the liver capsule. In fulminant forms of acute viral hepatitis, diffuse or focal necrosis may be detected on MR images.
In patients suffering from chronic hepatitis, cross-sectional imaging, especially MRI, is performed to determine the presence of cirrhosis or ascites and to screen for the presence of hepato-cellular carcinoma (HCC). A region of high SI surrounding the portal vein branches can frequently be found on T2-weighted images in patients suffering from acute or chronic active hepatitis, but is considered a non-specific sign . In addition, diffuse or regional high signal areas can be identified on T2-weighted images [58,59].
Patients with viral hepatitis typically have enlarged lymph nodes at the liver hilum presenting as solitary or confluent. However, in contrast to lymph node metastasis, the portal veins and other structures are not compressed and maintain their shape.
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