Date of hepatic or liver imaging test
Item
Date of hepatic or liver imaging test
date
Item
What method was used for this imaging test?
text
Code List
What method was used for this imaging test?
CL Item
Ultrasound - transdominal (1)
CL Item
Ultrasound - endoscopic (2)
CL Item
Magnetic Resonance Imaging (MRI) (3)
CL Item
Computerised Tomography (CT) (4)
CL Item
Endoscopic Retrograde CHolangiopancreatography (ERCP) (5)
CL Item
Positron Emission Tomography (PET) (6)
CL Item
Positron Emission Tomography/Computed Tomography (PET/CT) (7)
If Other, specify
Item
If Other, specify
text
Item
Are images technically adequate?
text
Code List
Are images technically adequate?
CL Item
Readable, but not optimal (2)
If Other, specify
Item
If Other, specify
text
Item
A. Indicate the liver size
text
Code List
A. Indicate the liver size
CL Item
Hypertrophy (or enlarged) (2)
CL Item
Atrophy (or smaller than normal) (3)
CL Item
Segmental hypertrophy (4)
If Other, specify
Item
If Other, specify
text
Item
B. Indicate the liver texture
text
Code List
B. Indicate the liver texture
CL Item
Heterogeneous (2)
CL Item
Suggestive of fibrosis (3)
CL Item
Nodular or suggestive of cirrhosis (4)
If Other, specify
Item
If Other, specify
text
Item
C. Grade the diffuse and/or geographic fatty infiltrate of the liver
text
Code List
C. Grade the diffuse and/or geographic fatty infiltrate of the liver
CL Item
Not applicable - no fatty infiltration (1)
CL Item
Moderate (>25% to <75%) (3)
CL Item
Severe (>=75%) (4)
If Other, specify
Item
If Other, specify
text
Item
D. Ascites present
text
Code List
D. Ascites present
CL Item
Yes - small amount (2)
CL Item
Yes - moderate or severe amount (3)
If Other, specify
Item
If Other, specify
text
Item
E. Are Focal Hepatic Lesions characterisable?
text
Code List
E. Are Focal Hepatic Lesions characterisable?
CL Item
Not applicable - no hepatic lesions (1)
CL Item
Focal nodular hyperplasia (5)
If Other, specify
Item
If Other, specify
text
Item
F. Gallstones or gallbladder lesions?
text
Code List
F. Gallstones or gallbladder lesions?
CL Item
Gallbladder polyps (3)
CL Item
Gallbladder wall thickening/Oedema (5)
CL Item
Gallbladder wall gas (6)
CL Item
Cholecystitis (7)
CL Item
Gallbladder wall calcification (8)
CL Item
Gallbladder mass (9)
If Other, specify
Item
If Other, specify
text
Item
G. Biliary ductal lesions
text
Code List
G. Biliary ductal lesions
CL Item
Intrahepatic ductal dilation (focal involving the right hepatic lobe) (2)
CL Item
Intrahepatic ductal dilation (focal involving the left hepatic lobe) (3)
CL Item
Intrahepatic ductal dilation (involving both right and left hepatic lobes) (4)
CL Item
Extrahepatic ductal dilation (5)
CL Item
Diffuse ductal dilation (involving both intrahepatic and extrahepatic ducts) (6)
CL Item
Acute cholangitis (7)
CL Item
Primary sclerosing cholangitis (8)
CL Item
Choledocholitiasis (gullstone in duct) (9)
CL Item
Ductal filling defect(s), other than gallstone (10)
CL Item
Ductal wall thickening or oedema (11)
CL Item
Choledochal cyst (12)
CL Item
Extrinsic mass compressing bile duct(s) (14)
If Other, specify
Item
If Other, specify
text
Item
H. Portal/Hepatic vein abnormalities
text
Code List
H. Portal/Hepatic vein abnormalities
CL Item
Portal vein enlargement (2)
CL Item
Hepatic vein enlargement (3)
CL Item
Nonocclusive portal vein thrombosis (4)
CL Item
Occlusive portal vein thrombosis - bland (5)
CL Item
Hepatic vein thrombosis - bland (6)
CL Item
Occlusive portal vein thrombosis - malignant (7)
CL Item
Hepatic vein thrombosis - malignant (8)
CL Item
Involvement of the main portal vein (9)
CL Item
Involvement of the right portal vein (10)
CL Item
Involvement of the left portal vein (11)
CL Item
Budd-Chiari syndrome (12)
If Other, specify
Item
If Other, specify
text
Date sample taken
Item
Date sample taken
date
Were liver chemistries (ALT, AST, ALP, bilirubin) performed?
Item
Were liver chemistries (ALT, AST, ALP, bilirubin) performed?
boolean
Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?
Item
Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?
boolean