Liver cysts in autosomal-dominant polycystic kidney disease: clinical and computed tomographic study.

Hepatic CT findings were analyzed in 44 patients with autosomal-dominant polycystic kidney disease and were correlated with liver and renal function tests and liver, splenic, and renal CT volume measurements. CT showed many large liver cysts in 31.8% of patients, small liver cysts in 25%, and no liver cysts in 43.2%. Patients with many large cysts often showed increased liver volumes. Splenic volumes did not differ significantly in patients with and without liver cysts, suggesting that portal hypertension is rarely associated with cystic liver disease. There was no correlation between severity of liver involvement and extent of renal cystic disease as determined from urea nitrogen and creatinine levels and renal volumes. Liver function tests were normal except in two patients, one with a cholangiocarcinoma, which may have arisen from a cyst, and the other with an infected liver cyst and chronic active hepatitis. Accordingly, if liver function tests are abnormal, an attempt should be made to identify complications of polycystic liver disease such as tumor, cyst infection, and biliary obstruction. Such complications are rare but may be seen in patients whose lives are prolonged by dialysis and renal transplantation. CT is a useful method for detecting liver cysts and identifying patients at risk for these complications.