Magnetic Resonance Imaging Evaluation of Hepatic Cysts in Early Autosomal-Dominant Polycystic Kidney Disease

Abstract

The objective of this study was to investigate the prevalence of hepatic cysts by age and gender in patients with early autosomal-dominant polycystic kidney disease (ADPKD) and to determine whether hepatic cyst volume is related to renal and renal cyst volumes by using magnetic resonance imaging (MRI). A total of 230 patients with ADPKD (94 men and 136 women) who were aged 15 to 46 yr and had relatively preserved renal function were studied. MRI images of the kidney and liver were obtained to measure renal, renal cyst, and hepatic cyst volumes. These volume measurements and hepatic cyst prevalence were compared in all patients and in subgroups on the basis of gender and age (15 to 24, 25 to 34, and 35 to 46 yr). The overall prevalence of hepatic cysts was 83%; the prevalence was 58, 85, and 94% in the sequential age groups and 85% in women and 79% in men. The prevalence was related directly to renal volume ( 2 ‫؍‬ 4.30, P ‫؍‬ 0.04) and to renal cyst volume ( 2 ‫؍‬ 5.59, P ‫؍‬ 0.02). The total hepatic cyst volume was significantly greater in women than in men (a logarithmic transformation mean of 5.27 versus 1.94 ml; P ‫؍‬ 0.003). The average hepatic cyst volume was 0.25, 5.75, and 22.78 ml in sequential age groups. Hepatic cysts are evident in 94% of patients who are older than 35 yr and in 55% of individuals who are younger than 25 yr. Hepatic cysts are more prevalent and larger in total cyst volume in women than in men. Hepatic cyst prevalence and aggregate total hepatic cyst volume increased with age.

Medical and surgical treatment options for polycystic liver disease1

“…The prevalence of hepatic cysts in ADPKD is high (67%-83%), and is likely age-dependent. 7,8 Risk factors for cyst growth are age, female sex, and renal cyst volume. 8 In addition, severity of renal cystic disease, prior pregnancies, and estrogen use predict increase of polycystic liver size in ADPKD.…”

“…7,8 Risk factors for cyst growth are age, female sex, and renal cyst volume. 8 In addition, severity of renal cystic disease, prior pregnancies, and estrogen use predict increase of polycystic liver size in ADPKD. 7,9 Indeed, 1 year of estrogen use in postmenopausal ADPKD patients selectively increases total liver volume by 7%, whereas total kidney volume remains unaffected.…”

Automated Segmentation of Kidneys from MR Images in Patients with Autosomal Dominant Polycystic Kidney Disease

“…ADPKD is characterized by bilateral enlarged kidneys containing numerous cysts that expand and compress surrounding renal parenchyma (3,4). For the assessment of the severity and the progression of ADPKD, total kidney volume (TKV) serves an important biomarker and also, inversely correlates with declining GFR (5,6).…”

Reducing Polycystic Liver Volume in ADPKD

“…Prevalence in ADPKD increases with age and approximates 95% by the age of 35 years (2). Symptoms worsen with time in parallel with progressive and massive enlargement of the liver and may be particularly severe in older patients who have survived long enough to progress to end-stage kidney disease and need for renal replacement therapy (1).…”