Liver involvement in patients with COVID-19 infection: A comprehensive overview of diagnostic imaging features.
Davide Ippolito, Cesare Maino, Federica Vernuccio, Roberto Cannella, Riccardo Inchingolo, Michele Dezio, Riccardo Faletti, Pietro Andrea Bonaffini, Marco Gatti, Sandro Sironi
Author Information
Davide Ippolito: Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy.
Cesare Maino: Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy.
Federica Vernuccio: Institute of Radiology (DIMED), University Hospital of Padova, Padova 35128, Italy.
Roberto Cannella: Section of Radiology-Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy.
Riccardo Inchingolo: Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy.
Michele Dezio: Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy.
Riccardo Faletti: Department of Surgical Sciences, University of Turin, Turin 10126, Italy.
Pietro Andrea Bonaffini: Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy.
Marco Gatti: Department of Diagnostic Radiology, University of Turin, Turin 10126, Italy.
Sandro Sironi: Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy.
During the first wave of the pandemic, coronavirus disease 2019 (COVID-19) infection has been considered mainly as a pulmonary infection. However, different clinical and radiological manifestations were observed over time, including involvement of abdominal organs. Nowadays, the liver is considered one of the main affected abdominal organs. Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs. After clinical assessment, radiology plays a key role in the evaluation of liver involvement. Ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) may be used to evaluate liver involvement. US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection, in particular liver steatosis and portal-vein thrombosis. CT and MRI are used as second- and third-line techniques, respectively, considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization. This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage.
