• Clinical Article •
MRI features of primary biliary cirrhosis and correlations with pathological staging
DOI:10.12015/issn.1674-8034.2016.03.006.
| [Abstract] Objective: To explore the features of primary biliary cirrhosis (PBC) on magnetic resonance imaging (MRI) and correlate them with pathological staging.Materials and Methods: MRI and pathologic findings of 50 patients with PBC (observation group) and 44 patients with other cirrhosis-causing liver diseases (control group) were analyzed, retrospectively. The severity of PBC was divided into stage Ⅰ—Ⅳ according to the histopathological changes. The MRI findings of the patients in the two groups were reviewed and compared, and the differences of MRI findings of PBC in different pathological stages were discussed.Results: The common MRI findings of PBC are the heterogeneous hyperintensity in the liver on T2WI, periportal long T2 signal intensity, periportal halo sign, decreased number and diameter of the intrahepatic bile ducts, liver parenchyma lace-like fibrosis, liver segmental atrophy or hypertrophy, abdominal lymphadenopathy, ascites and splenomegaly. The differences of the demonstrating frequencies on MRI were statistically significant in the periportal halo sign (χ2=6.887, P<0.05), decreased intrahepatic bile ducts (χ2= 5.537, P<0.05), and lymphadenopathy (χ2= 22.297, P<0.05) between the observation group and control group. Among the patients with PBC in varied histological stages, the demonstrating frequencies on MRI between stage II and stage III were significantly different in the periportal halo sign (P<0.05), and a decreased number and diameter of the intrahepatic bile ducts (P<0.05), but not in the lymphadenopathy (P>0.05).Conclusions: MRI findings of PBC were correlated with pathological staging, and the MRI examination was beneficial to evaluate the severity of the disease. |
| [Keywords] Liver Cirrhosis, Biliary；Magnetic resonance imaging；Pathology |
HAN Dan Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
YUAN Yan-wen Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
ZHANG Jie Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
XU Yan Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
JIN Er-hu* Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
HE Wen* Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
*Correspondence to: Jin EH, E-mail: erhujin@263.net. He W, E-mail: hewen1724@sina.com
Conflicts of interest None.
| ACKNOWLEDGMENTS This work was supported by Beijing Talented Youth Cultivation Project No. 2013B008001000009 |
| Received 2016-01-10 |
| Accepted 2016-02-10 |
| DOI: 10.12015/issn.1674-8034.2016.03.006 |
| DOI:10.12015/issn.1674-8034.2016.03.006. |
[1]
Carey EJ, Ali AH, Lindor KD. Primary biliary cirrhosis. Lancet, 2015, 86(10003): 1565-1575.
[2]
Nguyen DL, Juran BD, Lazaridis KN. Primary biliary cirrhosis. Best Pract Res Clin Gastroenterol, 2010, 24(5): 647-654.
[3]
Uibo R, Kisand K, Yang CY, et al. Primary biliary cirrhosis: a multi-faced interactive disease involving genetics, environment and the immune response. APMIS, 2012,120(11): 857-871.
[4]
Hohenester S, Oude-Elferink RP, Beuers U. Primary biliary cirrhosis. Semin Immunopathol, 2009, 31(3): 283-307.
[5]
Guanabens N, Pares A, Ros I, et al. Severity of cholestasis and advanced histological stage but not menopausal status are the major risk factors for osteoporosis in primary biliary cirrhosis. J Hepatol, 2005, 42(4): 573-577.
[6]
Longo M, Crosignani A, Battezzati PM, et al. Hyperlipidaemic state and cardiovascular risk in primary biliary cirrhosis. Gut, 2002, 51(2): 265-269.
[7]
Kim KA, Jeong SH. The diagnosis and treatment of primary biliary cirrhosis. Korean J Hepatol, 2011, 17(3): 173-179.
[8]
Ungprasert P, Wijarnpreecha K, Thongprayoon C. Risk of cerebrovascular accident in patients with primary biliary cirrhosis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol, 2016, 28(1): 90-94.
[9]
Kouroumalis E, Notas G. Primary biliary cirrhosis: from bench to bedside. World J Gastrointest Pharmacol Ther, 2015, 6(3): 32-58.
[10]
Tana MM, Shums Z, Milo J, et al. The significance of autoantibody changes over time in primary biliary cirrhosis. Am J Clin Pathol, 2015, 144(4): 601-606.
[11]
Haliloglu N, Erden A, Erden I. Primary biliary cirrhosis: evaluation with T2-weighted MR imaging and MR cholangiopancreatography. Eur J Radiol, 2009, 69(3): 523-527.
[12]
Takeyama Y, Tsuchiya N, Kunimoto H, et al. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging as a useful detection method for advanced primary biliary cirrhosis. Hepatol Res, 2015, 45(10): e108-114.
[13]
Ali AH, Carey EJ, Lindor KD. Diagnosis and management of primary biliary cirrhosis. Expert Rev Clin Immunol, 2014,10(12):1667-1678.
[14]
Floreani A, Motta R, Cazzagon N, et al. The overlap syndrome between primary biliary cirrhosis and primary sclerosing cholangitis. Dig Liver Dis, 2015, 47(5): 432-435.
[15]
Purohit T, Cappell MS. Primary biliary cirrhosis: pathophysiology, clinical presentation and therapy. World J Hepatol, 2015, 7(7): 926-941.
[16]
Marchioni Beery RM, Vaziri H, Forouhar F. Primary biliary cirrhosis and primary sclerosing cholangitis: a review featuring a women's health perspective. J Clin Transl Hepatol, 2014, 2(4): 266-284.
[17]
Gulamhusein AF, Juran BD, Lazaridis KN. Genome-wide association studies in primary biliary cirrhosis. Semin Liver Dis, 2015, 35(4): 392-401.
[18]
Czul F, Levy C. Novel therapies on primary biliary cirrhosis. Clin Liver Dis, 2016, 20(1): 113-130.
[19]
Trivedi PJ, Hirschfield GM. Primary biliary cirrhosis: renaming primary biliary cirrhosis-clarity or confusion? Nat Rev Gastroenterol Hepatol, 2015, 12(12): 678-679.
[20]
Kobayashi S, Matsui O, Gabata T, et al. Intrahepatic periportal high intensity on hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI: imaging findings and prevalence in various hepatobiliary diseases. Jpn J Radiol, 2013, 31(1): 9-15.
[21]
Jopson L, Dyson JK, Jones DE. Understanding and treating fatigue in primary biliary cirrhosis and primary sclerosing cholangitis. Clin Liver Dis, 2016, 20 (1): 131-142.
[22]
Oliveira EM, Oliveira PM, Becker V, et al. Overlapping of primary biliary cirrhosis and small duct primary sclerosing cholangitis: first case report. J Clin Med Res, 2012, 4 (6): 429-433.
[23]
Kovač JD, Ješić R, Stanisavljević D, et al. Integrative role of MRI in the evaluation of primary biliary cirrhosis. Eur Radiol, 2012, 22(3): 688-694.
[24]
Kobayashi S, Matsui O, Gabata T, et al. MRI findings of primary biliary cirrhosis: correlation with Scheuer histologic staging. Abdom Imaging, 2005, 30 (1): 71-76.
[25]
Liang Y, Yang Z, Zhong R. Primary biliary cirrhosis and cancer risk: a systematic review and meta-analysis. Hepatology, 2012, 56 (4): 1409-1417.
[26]
陈鑫, 梁长虹, 刘再毅. 磁共振扩散加权成像在肝脏中的应用.磁共振成像, 2013, 4 (1): 76-80.
[27]
陈丽华, 刘爱连, 马春梅. DTI评估大鼠肝纤维化及早期肝硬化的实验研究. 磁共振成像, 2014, 5 (5): 367-371.
[28]
邓乾华, 阮继银, 江锦赵, 等. 磁共振扩散加权成像在家兔肝纤维化分期的诊断价值. 磁共振成像, 2015, 6 (6): 467-470.
[29]
刘朋, 柴军, 洪旭, 等. 1H MRS对初诊2型糖尿病患者胰腺脂肪沉积的量化及与胰岛β细胞功能的关系研究. 磁共振成像, 2015, 6 (5): 364-369.
