Abdominal Cross-sectional Imaging for Inpatients With Abnormal Liver Function Test Results

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Abstract
LABORATORY AND radiologic tests have 3 major roles in patient care: screening, diagnosis, and management1; for abdominal imaging, diagnosis is most important. Noninvasive diagnostic imaging is frequently used in the evaluation and management of hospitalized patients with abdominal disease, especially in the hepatobiliary tract.2 While imaging is often very useful, patients with liver disease can be accurately diagnosed with only a history, physical examination, and biochemical liver tests in an estimated 80% of cases.3 The primary modalities currently used for diagnostic imaging of the liver and biliary tract are ultrasonography (US), computed tomography (CT), and, to a lesser extent, magnetic resonance imaging (MRI).4 While radionuclide studies, such as hepatobiliary scintography, are additional useful noninvasive modalities, they are less frequently requested for the initial investigation of abnormal laboratory test results. Recent improvements in noninvasive technologies have markedly changed the roles of interventional techniques (angiography and cholangiography), and they are now used mostly in therapeutic or secondary diagnostic roles.2 Cost has also become an important consideration in deciding how to best use these technologies.5

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