Chronic hepatitis: correlation of early patchy and late linear enhancement patterns on gadolinium-enhanced MR images with histopathology initial experience.
Semelka RC, Chung JJ, Hussain SM, Marcos HB, Woosley JT.: J Magn Reson Imaging 2001 Mar;13(3):385-91
The purposes of our study
were to describe the early and late enhancement patterns of the
liver on gadolinium-enhanced dynamic magnetic resonance (MR) images
in patients with chronic hepatitis and to correlate these findings
with histopathology. Patients were entered into the study based
on the presence of chronic hepatitis, imaging evaluation with
MR imaging (MRI), including early and late postgadolinium images,
and histopathologic correlation. Early and late dynamic postgadolinium
MR images of 29 consecutive patients with a pathologically proven
diagnosis of chronic hepatitis were retrospectively evaluated
for the presence of three types of enhancement, i.e., homogeneous,
linear, and patchy. Correlation was made between the enhancement
patterns on MR images and blinded retrospective interpretation
of the histopathologic specimens, which were obtained within 3
months of the MR examination. Of the 29 patients, 16 (55.2%) patients
showed patchy enhancement on the early gadolinium-enhanced MR
images. In 11 (68.8%) of these 16 patients, histopathology demonstrated
numerous macrophages, variable hepatocyte necrosis, and increased
steatosis. The remaining 13 (44.8%) patients showed homogeneous
enhancement on the early gadolinium-enhanced MR images. In 11
(84.6%) of these 13 patients, histopathology demonstrated few
or no macrophages, little or no hepatocellular necrosis, and little
or no steatosis. The correlation between patchy enhancement and
acute liver inflammation was significant (P = 0.005). On the late
gadolinium-enhanced MR images, 20 (69.0%) of 29 patients showed
prominent linear enhancement. In 19 (95.0%) of these 20 patients,
histopathology revealed hepatic fibrosis. We concluded that in
patients with chronic hepatitis, the presence of early patchy
enhancement indicates either concurrent or recent hepatocellular
damage, whereas the presence of late linear enhancement indicates
the presence of fibrosis, with a high degree of correlation with
histopathologic findings.
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