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• EXPERIENCE EXCHANGES •
Clinical and imaging identification between hepatic amyloidosis and hepatic sinusoidal obstructive syndrome
WANG Wei  LI Xueqin  ZHANG Haiying  WANG Xinxin  LI Hongjun 

Cite this article as: Wang W, Li XQ, Zhang HY, et al. Clinical and imaging identification between hepatic amyloidosis and hepatic sinusoidal obstructive syndrome[J]. Chin J Magn Reson Imaging, 2021, 12(2): 74-78. DOI:10.12015/issn.1674-8034.2021.02.017.


[Abstract] Objective The pathological site of hepatic amyloidosis and hepatic sinusoidal obstruction syndrome is the space of disse. The imaging findings can be similar, but the clinical manifestations lack specificity. It is easy to be misdiagnosed due to lack of clinical understanding. To summarize the clinical and imaging characteristics of hepatic amyloidosis and hepatic sinusoidal obstruction syndrome, and to improve the diagnosis of the two diseases. Materials andMethods Reviewed the clinical and imaging data of 11 patients with hepatic amyloidosis and 20 patients with hepatic sinusoidal obstruction syndrome diagnosed pathologically in Beijing You'an Hospital from 2009 to 2019, and compared their differences.Results (1) The typical clinical features of hepatic amyloidosis were giant liver, slight liver damage but significant increased in ALP and GGT. Most patients with hepatic sinusoidal obstruction syndrome in China had taken tunotoginseng history. The clinical features were mostly jaundice with liver. Functional impairment, coagulation dysfunction and increased CA125 were the main manifestations. (2) Imaging examination: ①The stiffness of liver amyloidosis on ultrasound was extremely high (≥75 kPa), which was significantly higher than that of sinusoidal obstruction syndrome [(44.65±19.01) kPa]; ②Hepatic amyloidosis on MRI T2WI, the liver parenchymal signal was uniform and fine, and the liver "texture" was reduced; the enhanced liver parenchymal enhancement was reduced and the enhancement peak was delayed. The liver parenchyma in the venous phase shows "windows Linghua "-like changes, which might be accompanied by low blood flow in the spleen or kidneys. Signs of perfusion, on the other hand, the T2WI liver parenchymal signal of hepatic sinus obstruction syndrome was unevenly increased, showing irregular patches or "cloudy"-like slightly high signal shadows; enhanced scan portal phase liver parenchyma could show map-like enhancement, surrounding three hepatic veins "Clover"-like enhancement, the delayed phase enhancement range was enlarged; ③Amyloidosis, the hepatic artery and the main portal vein diameter were larger than the hepatic sinusoidal obstruction syndrome patients (P＜0.05); the common point of the images of the two cases was the venous phase Ⅲ. The branch hepatic veins were not visible or appear slender.Conclusions There are some differences on the cause, clinical characteristic, and characteristic of images between hepatic amyloidosis and hepatic sinusoidal obstructive syndrome, all of them contribute to differential diagnosis.
[Keywords] hepatic amyloidosis；hepatic sinusoidal obstructive syndrome；imaging features；differential diagnoses；magnetic resonance imaging

WANG Wei   LI Xueqin   ZHANG Haiying   WANG Xinxin   LI Hongjun*  

Medical Imaging Center of Beijing You 'an Hospital Affiliated to Capital Medical University, Beijing 100069, China

Li HJ, E-mail: lihongjun00113@ccmu.edu.cn

Conflicts of interest   None.

Received  2020-10-27
Accepted  2021-01-13
DOI: 10.12015/issn.1674-8034.2021.02.017
Cite this article as: Wang W, Li XQ, Zhang HY, et al. Clinical and imaging identification between hepatic amyloidosis and hepatic sinusoidal obstructive syndrome[J]. Chin J Magn Reson Imaging, 2021, 12(2): 74-78. DOI:10.12015/issn.1674-8034.2021.02.017.

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