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Endoscopic Ultrasound (EUS):
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Updated: Jul 9, 2025

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ACR Appropriateness Criteria® Abnormal Liver Function Tests.

, Hina Arif-Tiwari1, Kristin K Porter2

  • 1University of Arizona, Banner University Medical Center, Tucson, Arizona.

Journal of the American College of Radiology : JACR
|December 1, 2023
PubMed
Summary
This summary is machine-generated.

Abnormal liver function tests indicate liver or bile duct issues. Imaging tests help identify causes and guide treatment for hepatocellular or cholestatic patterns.

Keywords:
AUCAlkaline phosphataseAppropriateness Criteriaappropriate use criteriabiliary obstructioncholestasisfatty liver diseasegamma-glutamyl transpeptidasehepatitishepatocellular predominancehyperbilirubinemialiver function tests

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Area of Science:

  • Hepatology
  • Radiology
  • Medical Diagnostics

Background:

  • Liver function tests (LFTs) are crucial for evaluating symptomatic and asymptomatic patients.
  • Abnormal LFTs can stem from hepatocellular or bile duct dysfunction, presenting diverse patterns.
  • Imaging is essential for diagnosing the cause and managing abnormal LFTs.

Purpose of the Study:

  • To outline imaging modalities for abnormal liver function tests.
  • To correlate LFT patterns with potential liver and bile duct pathologies.
  • To provide evidence-based guidelines for imaging in liver dysfunction.

Main Methods:

  • Review of initial and complementary imaging modalities for abnormal LFTs.
  • Application of American College of Radiology Appropriateness Criteria.
  • Utilizing evidence-based methodology like GRADE and expert consensus.

Main Results:

  • LFTs can show hepatocellular predominance (e.g., in liver disease, hepatitis) or cholestatic patterns (e.g., obstructive biliopathy).
  • Imaging guides diagnosis for prehepatic, intrahepatic, or posthepatic causes of hyperbilirubinemia and cholestasis.
  • Guidelines help determine appropriate imaging for specific clinical scenarios.

Conclusions:

  • Imaging plays a vital role in diagnosing and managing patients with abnormal liver function tests.
  • A systematic approach using established criteria ensures appropriate test selection.
  • Evidence-based guidelines and expert opinion inform imaging decisions for liver conditions.