Which finding on imaging is more typical of early cirrhosis?

Which finding on imaging is more typical of early cirrhosis?

• A. Hepatomegaly with hyperechoic liver
• B. Shrunken liver with coarse texture
• C. Normal liver size
• D. Splenomegaly with hypoechoic liver

Answer: (A)

Early cirrhosis often starts with the liver enlarging and becoming brighter on ultrasound due to fatty change and mild inflammatory/fibrotic activity. This gives a hepatomegaly with increased echogenicity (hyperechoic liver), reflecting these early parenchymal changes before the organ becomes small or develops a nodular surface. As cirrhosis advances, the liver typically shrinks and takes on a coarse, nodular texture, and portal hypertension may lead to splenomegaly. The other patterns—a small, coarse, nodular liver; a normal-sized liver; or splenomegaly with a hypoechoic liver—fit later stages or different processes rather than early cirrhosis.

Early cirrhosis often starts with the liver enlarging and becoming brighter on ultrasound due to fatty change and mild inflammatory/fibrotic activity. This gives a hepatomegaly with increased echogenicity (hyperechoic liver), reflecting these early parenchymal changes before the organ becomes small or develops a nodular surface. As cirrhosis advances, the liver typically shrinks and takes on a coarse, nodular texture, and portal hypertension may lead to splenomegaly. The other patterns—a small, coarse, nodular liver; a normal-sized liver; or splenomegaly with a hypoechoic liver—fit later stages or different processes rather than early cirrhosis.