MR Imaging Findings in Autoimmune Hepatitis: Correlation with Clinical Staging

Bilaj, Fatmir; Hyslop, W. Brian; Rivero, Hedrick; Fırat, Zeynep; Vaidean, Georgeta; Shrestha, Roshan; Woosley, John T.; Semelka, Richard C.

doi:10.1148/radiol.2363041262

Cited by 32 publications

(32 citation statements)

References 16 publications

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“…Conversely, the negative findings on MRCP might not completely exclude early-stage SC, because MRCP is considered by some authors of lower sensitivity than ERCP for the diagnosis of proximal bile duct lesions, even if this has not been clearly demonstrated in the field of PSC. 25,26 Bilaj et al 27 have recently documented the MRI appearance of AIH, and this report is consistent with our data. The authors observed mild IHBD dilatation in 12% of AIH patients (4/32 patients).…”

Section: Discussionsupporting

confidence: 93%

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

et al. 2009

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The development of sclerosing cholangitis (SC) is observed in up to 50% of children followed up for autoimmune hepatitis (AIH). In adults, the prevalence is less known, although a recent study found evidence of SC in 10% of AIH patients using magnetic resonance cholangiopancreatography (MRCP). The aim of this study was to assess prospectively the prevalence of SC in adults with AIH. Fifty-nine consecutive patients with AIH diagnosed according to International Autoimmune Hepatitis Group score (women, 71%; mean age, 48 years; cirrhosis, 23%) underwent both MRCP and percutaneous liver biopsy. Twenty-seven patients with cirrhosis of nonbiliary or non-autoimmune etiology served as controls. Fourteen AIH patients (24%) showed mild MRCP abnormalities of intrahepatic bile ducts (IHBDs). None had abnormal common bile duct or convincing evidence of SC on MRCP or biopsy. A diagnosis of overlapping SC was nevertheless retained in one patient with MRCP abnormalities who subsequently developed symptomatic cholestasis despite corticosteroid therapy. Fibrosis score was the only independent parameter associated with bile duct abnormalities on MRCP (odds ratio 2.4; 95% confidence interval 1.4-4.7) and the percentage of patients with IHBD MRCP abnormalities was not different among F3-F4 AIH patients (n ‫؍‬ 24) and cirrhotic controls (46% versus 59%; NS). Conclusion: In this cohort of adult patients with AIH, the prevalence of SC was much lower than previously reported (1.7%). Mild MRCP abnormalities of IHBD were seen in a quarter of patients, but these abnormalities resulted from hepatic fibrosis and not SC. In the absence of cholestatic presentation, MRCP screening does not seem justified in adult-onset AIH. (HEPATOLOGY 2009;50:528-537.)

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Section: Discussionsupporting

confidence: 93%

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

et al. 2009

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“…The characteristic imaging findings of fibrosis depending on the etiology of cirrhosis are also seen; for example, AIH shows mostly extensive reticular and/or confluent fibrosis [31], PBC frequently shows lace-like pattern fibrosis [32], and alcoholic cirrhosis occasionally shows confluent fibrosis [4] also demonstrated in this study. The distinct amount of histological fibrosis promoted by metabolic production of alcohol in alcoholic cirrhosis [33] may have some relation with the difference in the appearance of fibrosis.…”

Section: Discussionsupporting

confidence: 67%

Confluent hepatic fibrosis in liver cirrhosis: possible relation with middle hepatic venous drainage

et al. 2013

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“…25 These characteristic histological findings of fibrosis, depending on the aetiology of cirrhosis, can be depicted by imaging. [26][27][28] Furthermore, progressive hepatic fibrosis evokes the so-called regenerative nodules in cirrhosis. 29 Cirrhosis is classified as macronodular, micronodular and mixed nodular based on the size of regenerative nodules, with this also tending to depend on aetiology.…”

Section: Discussionmentioning

confidence: 99%