Ji Hun Kang1,2,3, Do Hyung Kim4, So Yeon Kim5,6, Hyo Jeong Kang2,7, Jung Bok Lee8, Kyoung Won Kim1,2, Seung Soo Lee1, Jonggi Choi2,9, Young-Suk Lim2,9. 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea. 2. Liver Cancer Center, Asan Medical Center, Seoul, Republic of Korea. 3. Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea. 4. University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 5. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea. sykim.radiology@gmail.com. 6. Liver Cancer Center, Asan Medical Center, Seoul, Republic of Korea. sykim.radiology@gmail.com. 7. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 8. Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 9. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Abstract
PURPOSE: To differentiate the computed tomography (CT) and magnetic resonance imaging (MRI) features of porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC). METHODS: In this retrospective case-control study of patients with PSVD matched in a 1:3 ratio with LC patients according to liver function, initial diagnosis and time to final diagnosis were analyzed. Imaging features on CT and the parenchymal enhancement on hepatobiliary phase of hepatobiliary agent-enhanced MRI (HBA-MRI) were compared using a generalized linear mixed model. Focal hepatic lesions in the PSVD group were analyzed. RESULTS: In total, 43 PSVD patients and 129 LC patients were included. Among PSVD patients, 72.1% were initially misdiagnosed with LC. PSVD patients had a longer diagnostic delay than LC patients (32 months vs. 4 months; p < 0.001). Liver surface nodularity was less common in the PSVD group than in the LC group (16.3% vs. 89.2%, p < 0.001). Increased caudate-to-right lobe ratio, heterogeneous parenchymal enhancement, and portal vein abnormalities were more frequently noted in the PSVD group than in the LC group (all p < 0.001). The grade of portal hypertension was significantly higher in the PSVD group than in the LC group (p < 0.001), and they also had brighter parenchymal enhancement during the hepatobiliary phase of HBA-MRI (p < 0.001). In the PSVD group, 14% patients had at least one focal hepatic lesion, primarily a focal nodular hyperplasia (FNH)-like nodule. CONCLUSIONS: Some imaging features on CT and HBA-MRI can distinguish PSVD from LC. Benign focal lesions, most commonly FNH-like nodules, can develop in PSVD.
PURPOSE: To differentiate the computed tomography (CT) and magnetic resonance imaging (MRI) features of porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC). METHODS: In this retrospective case-control study of patients with PSVD matched in a 1:3 ratio with LC patients according to liver function, initial diagnosis and time to final diagnosis were analyzed. Imaging features on CT and the parenchymal enhancement on hepatobiliary phase of hepatobiliary agent-enhanced MRI (HBA-MRI) were compared using a generalized linear mixed model. Focal hepatic lesions in the PSVD group were analyzed. RESULTS: In total, 43 PSVD patients and 129 LC patients were included. Among PSVD patients, 72.1% were initially misdiagnosed with LC. PSVD patients had a longer diagnostic delay than LC patients (32 months vs. 4 months; p < 0.001). Liver surface nodularity was less common in the PSVD group than in the LC group (16.3% vs. 89.2%, p < 0.001). Increased caudate-to-right lobe ratio, heterogeneous parenchymal enhancement, and portal vein abnormalities were more frequently noted in the PSVD group than in the LC group (all p < 0.001). The grade of portal hypertension was significantly higher in the PSVD group than in the LC group (p < 0.001), and they also had brighter parenchymal enhancement during the hepatobiliary phase of HBA-MRI (p < 0.001). In the PSVD group, 14% patients had at least one focal hepatic lesion, primarily a focal nodular hyperplasia (FNH)-like nodule. CONCLUSIONS: Some imaging features on CT and HBA-MRI can distinguish PSVD from LC. Benign focal lesions, most commonly FNH-like nodules, can develop in PSVD.
Authors: Andrea De Gottardi; Pierre-Emmanuel Rautou; Jeoffrey Schouten; Laura Rubbia-Brandt; Frank Leebeek; Jonel Trebicka; Sarwa Darwish Murad; Valérie Vilgrain; Virginia Hernandez-Gea; Filipe Nery; Aurélie Plessier; Annalisa Berzigotti; Paulette Bioulac-Sage; Massimo Primignani; David Semela; Laure Elkrief; Pierre Bedossa; Dominique Valla; Juan Carlos Garcia-Pagan Journal: Lancet Gastroenterol Hepatol Date: 2019-05
Authors: Alyssa M Krasinskas; Bijan Eghtesad; Patrick S Kamath; Anthony J Demetris; Susan C Abraham Journal: Liver Transpl Date: 2005-06 Impact factor: 5.799