Discrepancy Between CT and MRI Findings of Liver Size
Subject: 35-year-old female, height 5'3", weight 110 lbs; not on any medications besides a calcium supplement, and previously took 1g of salt tablets from June through July. Backstory: In April, I began experiencing a worsening of chronic symptoms alongside some new issues. This culminated in a visit to the emergency room due to near-fainting spells and low blood pressure. I also noticed a significant decrease in my appetite, which made eating quite uncomfortable, leading to a weight loss of approximately 10-15 lbs. Upon consulting a new primary care physician, I underwent extensive blood tests. The results largely appeared normal, including liver function tests, although my serum iron and transferrin saturation levels were elevated. Consequently, I was referred to a hematologist, who diagnosed me with hemochromatosis and recommended a liver MRI to check for potential iron deposits. Simultaneously, my PCP ordered an abdominal CT scan to investigate my early satiety issues. The abdominal CT scan conducted in late June returned normal results, specifically noting that my liver was “within normal parameters.” Due to scheduling conflicts, I only managed to get the liver MRI this past week (September). The findings indicated a mildly enlarged liver, measuring 19 cm. Reflecting on my alcohol consumption, I used to drink heavily in my twenties—averaging 4-8 beverages on most nights. Though I moderated my drinking in my thirties, prior to the ER visit in April, I was still consuming about 2-4 beers on an evening, sometimes reaching 5 drinks. Since then, I’ve significantly cut down to 0-1 beer most nights, and a maximum of 2-3 drinks once or twice a week. Despite some ongoing appetite loss, I maintain a well-rounded omnivorous diet, primarily composed of homemade meals rich in fruits and vegetables. I avoid excessive consumption of fried foods and saturated fats, opting for a balanced approach instead. I have consulted with a cardiologist who performed an echocardiogram and a continuous EKG monitor, finding nothing alarming. He added me to salt tablets temporarily for low blood pressure, which I discontinued in July as my readings stabilized. Furthermore, my hematologist confirmed that my bloodwork did not suggest any cancer risk. In summary, I'm puzzled by how my liver could appear normal on the June CT scan while the MRI in September indicated a size of 19 cm, especially in light of my reduced alcohol intake. Could the enlargement simply have not been detectable on the CT? Also, how concerning is a liver measuring 19 cm for someone who is 35 years old and weighs 110 lbs? Any insights would be greatly appreciated as I await communication from my healthcare providers, hopefully by Monday.
Answers (1)
9/13/2025, 4:20:49 AM
OpenHealth AI
Your situation regarding the discrepancy between the CT and MRI findings of your liver size is understandably concerning, especially given your health history and recent symptoms. Let’s break this down to understand it better and provide you with actionable insights.
Key Points
- Discrepancy in Imaging Results: The difference in liver size between the CT and MRI could be due to the different imaging techniques and their sensitivity to detect certain changes.
- Current Condition Monitoring: A mildly enlarged liver is noteworthy and should be monitored, especially given your hematologist's diagnosis of hemochromatosis.
- Lifestyle Factors: Your reduced alcohol intake and balanced diet are positive changes for your liver health.
Explanation
Imaging Techniques: CT scans and MRIs use different technology to capture images of organs. Sometimes, certain conditions like mild enlargement might be more apparent on an MRI, which can provide more detailed images of soft tissues compared to a CT scan. Therefore, it is possible for the CT to report a "normal" liver size while an MRI might detect subtle changes or enlargement.
Liver Size Measurement: In adults, a normal liver size usually measures around 15-17 cm in length. A liver size of 19 cm is considered mildly enlarged and could suggest early liver disease or other conditions. It's important to interpret this finding in the context of your overall health, laboratory results, and symptoms.
Next Steps
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Monitor Symptoms: Continue to keep track of any symptoms such as appetite changes, weight loss, or discomfort. Documenting these changes can provide useful information to your healthcare providers.
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Follow Up with Healthcare Providers: Contact your primary care physician and hematologist about the MRI results. They may want to repeat blood tests to monitor liver function or iron levels, or perform further imaging if necessary.
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Lifestyle Considerations:
- Maintain your reduced alcohol consumption as it can significantly benefit liver health.
- Continue your balanced diet with foods high in antioxidants, such as fruits and vegetables, and consider foods rich in omega-3 fatty acids like fish.
- Stay hydrated and avoid any substances that can further stress your liver, such as excessive medications or supplements not prescribed by your doctor.
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Prepare Questions: When you meet with your healthcare team, consider asking about:
- Potential implications of the enlarged liver and what follow-up might be needed.
- Recommendations for managing your hemochromatosis effectively.
- Any need for additional lifestyle modifications.
Conclusion
Your concern about liver size is valid, and it’s wise to stay proactive. While it's understandable to be worried about discrepancies in test results, discussing them with your healthcare providers will yield the most accurate follow-up steps tailored to your needs. Remember, you're actively participating in your health, which is a significant step forward. If you have any further concerns, I'm here to help.
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