Chronic hepatitis: Correlation of early patchy and late linear enhancement patterns on gadolinium-enhanced MR images with histopathology initial experience

Richard C. Semelka, Jae Joon Chung, Shahid M. Hussain, Hani B. Marcos, John T. Woosley

Research output: Contribution to journalArticle

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Abstract

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 Mil 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 (44.80/0) 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.

Original languageEnglish (US)
Pages (from-to)385-391
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume13
Issue number3
DOIs
StatePublished - Mar 6 2001

Fingerprint

Gadolinium
Chronic Hepatitis
Magnetic Resonance Spectroscopy
Liver
Fibrosis
Necrosis
Macrophages
Hepatocytes
Magnetic Resonance Imaging
Inflammation

Keywords

  • Cirrhosis
  • Gadolinium
  • Hepatitis
  • Liver
  • MR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Chronic hepatitis : Correlation of early patchy and late linear enhancement patterns on gadolinium-enhanced MR images with histopathology initial experience. / Semelka, Richard C.; Chung, Jae Joon; Hussain, Shahid M.; Marcos, Hani B.; Woosley, John T.

In: Journal of Magnetic Resonance Imaging, Vol. 13, No. 3, 06.03.2001, p. 385-391.

Research output: Contribution to journalArticle

Semelka, Richard C. ; Chung, Jae Joon ; Hussain, Shahid M. ; Marcos, Hani B. ; Woosley, John T. / Chronic hepatitis : Correlation of early patchy and late linear enhancement patterns on gadolinium-enhanced MR images with histopathology initial experience. In: Journal of Magnetic Resonance Imaging. 2001 ; Vol. 13, No. 3. pp. 385-391.
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abstract = "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 Mil 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 (44.80/0) 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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