Discrimination of Alcoholic from Virus-Induced Cirrhosis on MR Imaging

Okazaki, H; Ito, Katsuyoshi; Fujita, Takeshi; Koike, Shinji; Takano, Katsuyuki; Matsunaga, Naofumi

doi:10.2214/ajr.175.6.1751677

Cited by 62 publications

(46 citation statements)

References 24 publications

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“…The distinct hypertrophy of the caudate lobe in alcoholic cirrhosis is the same as that noted in a previous study. 15 In patients with NASH classified as patients with Child-Pugh Class A, these morphometric changes other than hypertrophy of the caudate lobe progressed less than in those with virus-related and alcoholic cirrhosis. The hypertrophy of the caudate lobe progressed more than in patients with virus-related cirrhosis, as well as in patients with alcoholic cirrhosis.…”

Section: Discussionmentioning

confidence: 96%

“…6,7,10,15 We for the first time revealed that NASH-related cirrhosis showed the same patterns of The proportion of lateral segment to the total liver was significantly smaller in patients with non-alcoholic steatohepatitis (NASH) than in those with alcoholic cirrhosis (p , 0.001), the proportion of the medial segment was significantly larger in patients with NASH than in those with alcoholic cirrhosis (p 5 0.045), the proportion of the anterior segment was significantly larger in the patients with NASH than in those with alcoholic cirrhosis (p 5 0.003) and the proportion of the caudate lobe was significantly smaller in the patients with virus-related cirrhosis than in those with alcoholic liver cirrhosis (p 5 0.001). There were no significant differences in the proportion of the posterior segment and right lobe to the total liver among the patients with the three different aetiologies (p .…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Morphometric changes of liver cirrhosis on imaging commonly include atrophy of the medial segment and right lobe and hypertrophy of the lateral segment and caudate lobe. [6][7][8][9][10][11][12][13][14] Although several reports have shown that morphometric variations of hepatic segments in cirrhosis differ depending on the aetiologies of cirrhosis, 15 these reports focused mainly only on a part of a segment such as the caudate lobe and analysed only virus-related or alcoholic cirrhosis, while most of them lumped together various aetiologies. [8][9][10][11][12][13][14] In addition to differences related to the underlying aetiology, morphometric changes may also depend on the progression of cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Ozaki¹,

Matsui²,

Kobayashi³

et al. 2016

BJR

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Ozaki¹,

Matsui²,

Kobayashi³

et al. 2016

BJR

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“…O encontro destas alterações pela RM corrobora as alterações descritas vistas na US . É interessante notar, no entanto, que outras afecções podem, eventualmente, cursar com essas alterações, mais notadamente a cirrose, seja ela de etiologia alcoó-lica ou viral (43,50) . A fibrose periportal já foi considerada patognomônica de esquistossomose e a sua caracterização é importante para a avaliação do estádio da doença, bem como para acompanhar o sucesso do tratamento (35,(53)(54)(55) .…”

Section: Discussionunclassified

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

et al. 2004

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OBJETIVO: Avaliar, qualitativa e quantitativamente, as alterações morfológicas hepáticas e esplênicas por ressonância magnética (RM) em pacientes portadores de esquistossomose mansônica crônica, e a reprodutibilidade do método na avaliação hepatoesplênica destes pacientes. MATERIAIS E MÉTODOS: Realizou-se estudo prospectivo em 28 pacientes esquistossomóticos submetidos à RM de abdome superior. Os exames foram realizados em equipamento com alto campo (1,5 T), utilizando-se bobina de corpo e bomba injetora para a administração do contraste endovenoso, e interpretados por dois examinadores independentes, que avaliaram a presença de alterações morfológicas hepáticas e esplênicas. A concordância interobservador e intra-observador foram medidas pelo teste kappa e pelo teste do coeficiente de correlação intraclasses. RE-SULTADOS: As variáveis qualitativas e quantitativas apresentaram boa concordância interobservador e intra-observador (κ ≥ κ ≥ κ ≥ κ ≥ κ ≥ 0,65 e r ≥ ≥ ≥ ≥ ≥ 0,66, respectivamente). A maior concordância interobservador foi obtida para o diâmetro ântero-posterior do baço (r = 0,98). Os observadores identificaram redução do lobo hepático direito, aumento do lobo hepático esquerdo e caudado associado a esplenomegalia em quase todos os pacientes, e alargamento de fissuras, heterogeneidade do parênquima hepático, irregularidade de contornos, vasos periféricos hepáticos e fibrose periportal em mais de 82% dos pacientes. CONCLUSÃO: As alterações morfológicas hepáticas caracterizam-se pela redução do lobo direito e aumento dos lobos caudado e esquerdo, e as esplênicas, pela presença de esplenomegalia e nódulos sideróticos. A RM apresenta elevada reprodutibilidade na avaliação dessas alterações em pacientes com esquistossomose mansônica crônica. Unitermos: Hepatopatias parasitárias; Esplenopatias; Esquistossomose mansoni; Ressonância magnética.Liver and spleen magnetic resonance imaging evaluation in patients with chronic Schistosoma mansoni infection. OBJECTIVE: To qualitatively and quantitatively evaluate the morphological changes of the liver and spleen using magnetic resonance imaging (MRI) in patients with chronic infection by Schistosoma mansoni and the reproducibility of MRI findings in the hepatosplenic evaluation of these patients. MATERIALS AND METHODS: We prospectively studied 28 schistosomotic patients submitted to MRI of the upper abdomen. The scans were performed using a high field equipment (1.5 T), a body coil and a power injector for administration of intravenous contrast. The scans were interpreted by two independent examiners who evaluated the presence of morphological changes in the liver and spleen. Interobserver and intraobserver agreement were measured using the kappa and intraclass correlation tests. RESULTS: Qualitative variables presented good interobserver and intraobserver agreement (κ ≥ κ ≥ κ ≥ κ ≥ κ ≥ 0.65 and r ≥ ≥ ≥ ≥ ≥ 0.66, respectively). The best interobserver agreement was for the anteroposterior diameter of the spleen (r = 0.98). The observers identified reduction of the right...

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“…On MRI, specific features suggestive for alcoholic cirrhosis versus virus-induced cirrhosis include a higher volume index of the caudate lobe, smaller size of regenerative nodules of the liver and more frequent visualization of the right posterior hepatic notch [6] . On US liver scan, the presence of "pseudoparallel channel signs" and of low hepatic artery resistivity index (RI) at duplex Doppler investigation have both been reported in AAH [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“Pseudotumoral” hepatic pattern in acute alcoholic hepatitis: A case report

Tenca

Massironi

Colli³

et al. 2009

WJG

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In acute alcoholic hepatitis (AAH), a "pseudotumoral" appearance of the liver parenchyma on computed tomography (CT) scan has been reported. The main findings are hypervascularized areas closely similar to those observed in large hepatocellular carcinomas. We report a case of a patient affected by AAH with an unusual appearance of these "pseudotumoral" areas on CT scan, close resembling a metastatic cancer rather than a primary hepatocellular carcinoma. In fact, in contrast with previous reports, the picture was characterized by the presence of many inhomogeneous, hypoattenuated areas highlighted during both preand post-contrast phases. Moreover, we report the first description of "pseudotumoral" lesions on ultrasound scan. This patient was successfully treated with corticosteroids, even if many controversies still exist regarding their efficacy in this setting.

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Discrimination of Alcoholic from Virus-Induced Cirrhosis on MR Imaging

Abstract: Enlargement of the caudate lobe and the presence of the right posterior hepatic notch on MR imaging are more frequent findings of alcoholic cirrhosis than of virus-induced cirrhosis.

Cited by 62 publications

References 24 publications

Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

“Pseudotumoral” hepatic pattern in acute alcoholic hepatitis: A case report

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