Published in:
01-03-2012 | Magnetic Resonance
Integrative role of MRI in the evaluation of primary biliary cirrhosis
Published in: European Radiology | Issue 3/2012
Login to get accessAbstract
Objectives
To evaluate magnetic resonance imaging (MRI) findings in patients with primary biliary cirrhosis (PBC) and to determine the value of diffusion-weighted imaging (DWI) in the assessment of liver fibrosis.
Materials and methods
The following MRI findings were reviewed in 44 patients: periportal T2-weighted hyperintensity, periportal halo sign (T1- and T2-weighted periportal hypointensity), lymphadenopathy, signs of portal hypertension and morphological liver changes. Apparent diffusion coefficient (ADC) was calculated for six locations in the liver for b = 800 s/mm2.
Results
Periportal hyperintensity and periportal halo sign were observed in 72.7% and 66.7% of patients, respectively. Lymphadenopathy was noted in 28 patients (63.6%) and diffuse hepatomegaly in 18 (40.9%). Significant positive correlation was observed between histological stage and periportal halo sign (p = 0.613), hepatomegaly (p = 0.443), and portosystemic collaterals (p = 0.391). The mean ADCs (×10−3 mm2/s) were significantly different at stage I versus III and IV, and stage II versus IV. No significant difference was found between stages II and III. For prediction of stage ≥ II and stage ≥ III areas under receiver operating characteristic curves were 0.879 and 0.906, respectively.
Conclusion
MRI with DWI could be used as a part of diagnostic protocol in the further evaluation of PBC patients providing noninvasive assessment of liver fibrosis progression.
Key Points
• MRI provides insight into the morphological liver changes in primary biliary cirrhosis (PBC)
• The periportal “halo” sign is a highly specific finding in PBC
• Diffusion-weighted MR imaging allows noninvasive assessment of liver fibrosis grade