Q. I had two CAT scans with and without contrast. Which is reliable?

Answered by
Dr. Divakara P
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 26, 2016 and last reviewed on: Nov 19, 2020

Hi doctor,

I had a CAT scan done two weeks ago with dye. It showed that my liver was normal. I had another one done yesterday as I am having problems with diverticulitis with dye and oral white drink. This one showed subtle roughness of liver, suggesting cirrhosis. I have had elevated liver enzymes for years and was told I had a fatty liver. Why did not my earlier scan show the same finding? But, these scans were done at two different places. Any information that you can give me would be greatly appreciated. I have been on Cymbalta for approximately 12 years and now I am being taken off due to elevated liver enzymes.



Welcome to icliniq.com.

Your question is really genuine.

  • Cirrhosis is a slowly evolving disease and it cannot occur in a matter of weeks. Hence, it is extremely unlikely that cirrhosis has happened in two weeks.
  • In my opinion, either one of the scan report is interpreted wrongly. In my opinion, subtle roughness does not confirm cirrhosis, though it can be suspected.
  • I am not very much convinced that you are having cirrhosis, but I do not recommend neglecting it either.
  • I shall give you two options. Wait for three weeks and do a repeat CAT scan or straight away go for a test called liver biopsy.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

I made a mistake. The CAT scan that I had two weeks ago was without contrast and dye. The one I had two days ago, which suggested cirrhosis, was with oral contrast and IV dye. Does this make a difference?



Welcome back to icliniq.com.

  • Well, it does make some difference. The one with contrast gives more details of the liver than the one without contrast.
  • So, the one with contrast can be relied more than the one without contrast. But, that still does not confirm the diagnosis of cirrhosis.
  • I recommend you to get a liver biopsy done for confirmation or to refute the diagnosis of cirrhosis.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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