Chronic hepatitis and cirrhosis: evaluation by means of MR imaging with histologic correlation.

Abstract

To characterize the relationship between findings on magnetic resonance (MR) images and histologic changes in chronic liver disease, a prospective study was performed in 100 patients with chronic hepatitis and cirrhosis and 28 healthy subjects. Biopsy specimens, obtained in all patients before MR imaging, were evaluated with the histologic activity (HA) index; MR images were obtained with short inversion time inversion-recovery (STIR) and spin-echo sequences. On STIR images, normal livers were iso-intense to fat. Significant differences (P < .001) existed between signal intensity of normal livers and that of diseased livers, which were brighter than normal livers on STIR images. The ratio of signal intensity of liver to that of fat on STIR images was associated with an HA index grouped by severity (P < .05): Patients with higher HA scores had a brighter liver. Signal intensity ratios on MR images were statistically significantly associated with periportal and lobular necrosis and portal inflammation. The signal intensity of liver on STIR images is associated with the degree of histologic severity in patients with chronic liver disease.

Intrahepatic Peripheral Cholangiocarcinoma in Cirrhosis Patients May Display A Vascular Pattern Similar to Hepatocellular Carcinoma on Contrast-Enhanced Ultrasound

“…We registered the radiological images of all patients with ICC and cirrhosis consecutively diagnosed in our institution between December 2003 and September 2009. The inclusion criteria were as follows: (1) patient with cirrhosis diagnosed by imaging, [17][18][19][20] pathology, and/or clinical criteria (presence of portal hypertension measured by hepatic vein catheterization or presence of esophageal varices at endoscopy); and (2) pathology-confirmed diagnosis of ICC by percutaneous biopsy or surgical specimen analysis. Patients with mixed hepatocellular-cholangiocarcinoma were excluded.…”

Overload hepatitides: quanti-qualitative analysis

“…Although these changes have a relationship with the presence and degree of fibrosis, both are independent and should not be rated as the same data. Necroinflammatory changes can be inferred with the use of STIR images [1], by evaluating the relative signal intensity of the liver compared with fat. This method, thereby, allows the diagnosis of steatohepatitis and the grading of the necroinflammatory infiltrate in cirrhosis.…”

“…Fat is related to steatosis and steatohepatitis; water to the necro-inflammatory activity in steatohepatitis, chronic hepatitis and cirrhosis; and iron to the different iron overload disorders and cirrhosis. Frequently, these different components coexist in the same condition [1].…”

“…Liver inflammation and hepatocyte necrosis are associated with an increase in the liver water content. Evaluation of the degree of water in the hepatic parenchyma can be assessed with the use of TSE-STIR images [1], allowing the diagnosis of steatohepatitis and semiquantitative grading of the necroinflammatory infiltration in chronic hepatitis and cirrhosis. MR spectroscopy (MRS) with un-suppressed water techniques may also be applied for the calculation of liver water content for the assessment of necroinflammatory tissue involvement.…”

MR imaging characteristics of hepatic tumors

“…In hepatocarcinogenesis in chronic liver disease there is a multistep continuous transition process [27] from hyperplasia (regenerative nodules) to dysplasia (adenomatous hyperplasia with or without atypia) to carcinoma (early and small HCC). Regenerative nodules are homogeneous small isointense nodular areas limited by mildly hyperintense fibrotic tracts [28]. On other occasions these nodules are hypointense on T2W images due to the accumulation of iron; these siderotic nodules are hypointense on all sequences.…”