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Porto-sinusoidal vascular disease with portal hypertension versus liver cirrhosis: differences in imaging features on CT and hepatobiliary contrast-enhanced MRI

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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.
Author(s)
강지훈김도형김소연강효정이정복김경원이승수최종기임영석
Issued Date
2021
Type
Article
Keyword
CT imagingGadoxetateGastroenterologyHepatobiliaryHepatologyImagingLiver cirrhosisMagnetic resonance imagingMedical researchMedicineMedicine &amp; Public HealthMedicineExperimentalPortal hypertensionRadiology
DOI
10.1007/s00261-020-02831-w
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7372
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2454108985&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Porto-sinusoidal%20vascular%20disease%20with%20portal%20hypertension%20versus%20liver%20cirrhosis:%20differences%20in%20imaging%20features%20on%20CT%20and%20hepatobiliary%20contrast-enhanced%20MRI&amp;offset=0&amp;pcAvailability=true
Publisher
ABDOMINAL RADIOLOGY
Location
미국
Language
영어
ISSN
2366-004X
Citation Volume
46
Citation Number
5
Citation Start Page
1891
Citation End Page
1903
Appears in Collections:
Medicine > Medicine
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