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

Question

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.

Answer 1

Hi,

Welcome to icliniq.com. Your concern is valid. cirrhosis typically develops gradually and isn't likely to occur within a couple of weeks. It seems improbable that cirrhosis could manifest in such a short timeframe. It's possible that there might be an error in interpreting one of the scan reports. While subtle roughness might raise suspicion, it doesn't definitively confirm cirrhosis. Based on the information provided, I'm not entirely convinced of a cirrhosis diagnosis, but I also advise against ignoring the situation. You have two options to consider: either wait for three weeks and repeat the CAT scan or proceed directly with a liver biopsy. Both approaches could provide more clarity on your condition.

Answer 2

Hi,

Welcome back to icliniq.com. Certainly, there is a distinction between the scans with and without contrast, with the contrast-enhanced scan offering more comprehensive liver details. Despite this, relying solely on the contrast scan isn't sufficient to confirm cirrhosis. To achieve a more definitive conclusion, my suggestion would be to undergo a liver biopsy. This procedure can either validate or dismiss the cirrhosis diagnosis, providing a clearer understanding of your condition.