Background Liver cirrhosis is the pathologic outcome of many chronic liver diseases, in which repeated injury to the liver results in fibrosis, scarring, and ultimately functional impairment (1). The classic defining histological evaluation of cirrhosis will reveal diffuse regenerative nodules surrounded by dense fibrosis, with parenchymal distortion and collapse causing disruption in hepatic vascular structures (2). There are many causes of cirrhosis, such as viral hepatitis, alcohol related fatty liver disease, non-alcoholic fatty liver disease (NAFLD), biliary diseases, Wilson's disease, alpha1-antitrypsin deficiency, and hemochromatosis (1, 3). Cirrhosis is regarded as an end-stage disease that has a high mortality, and liver transplantation serves as the only true curative treatment (2). However, due to recent advances in treatment and management of patients with chronic liver disease, early detection allows for early treatment, which leads to favorable patient outcomes (4). Imaging and image-guided procedures have a role in prevention, screening, diagnosis, and management of cirrhosis (2). It is important to establish the diagnosis of cirrhosis early in the disease process for a variety of reasons. It has been shown that fibrosis even in later stages of disease may regress with specific therapy, such as in the case with chronic hepatitis B and chronic hepatitis C (2). The challenge is that chronic liver disease is often asymptomatic until the patient develops cirrhosis and decompensates with signs of sepsis, ascites, variceal hemorrhage, encephalopathy, or non-obstructive jaundice (2). The gold standard for diagnosis of cirrhosis has traditionally been a liver biopsy (3, 4). Currently, minimally invasive methods such as radiological imaging (ultrasound, computed tomography, and magnetic resonance imaging) and serum markers have become more favorable options in diagnosis, staging, and grading of chronic liver diseases (4). Most physicians rely on imaging and clues of impaired hepatic function as the major basis for diagnosis of cirrhosis. The prognosis is highly variable for cirrhosis with a one-year mortality ranging from 1%-57% depending on the stage (2).
