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 21 November 2017

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News

Staging autoimmune Hepatitis using magnetic resonance

Fibrosis is a common feature in autoimmune hepatitis and is often moderate to severe, although this recent study in Radiology found no correlation between fibrosis grade and MELD score.

News image

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Dr Richard Semelka evaluated the morphologic and enhancement features of the liver on magnetic resonance images of autoimmune hepatitis.

The research team determined if there is a correlation between magnetic resonance imaging findings and severity of clinical disease.

Severity of clinical liver disease was measured with the Mayo end-stage liver disease (MELD) score.

The team reported that the study was compliant with the Health Insurance Portability and Accountability Act, approved by the institutional review board.

The need for informed consent was waived.

Of 32 patients, 29 were female with a mean age of 44 years.

All patients receiving treatment for autoimmune hepatitis underwent unenhanced and gadolinium-enhanced magnetic resonance imaging.

All cases were independently reviewed by 2 radiologists to determine the presence of patchy or heterogeneous liver enhancement.

94% had reticular fibrosis with a mean MELD grade of 2
Radiology

The independent reviewers also determined biliary duct changes, lymphadenopathy, and findings of portal hypertension.

The researchers graded fibrosis as mild, moderate, or severe reticular corresponding to a grading scale of 1 to 3 or as confluent.

Agreement between radiologists was assessed by using coefficients.

Mean MELD scores were compared across fibrosis categories by using the Kruskal-Wallis analysis of variance.

The research team reported that 6% had no imaging findings of cirrhosis.

The researchers found that 94% had reticular fibrosis with a mean grade of 2.

The team observed that 6 patients had confluent fibrosis, and all 6 had associated reticular fibrosis.

Mild intrahepatic biliary duct dilatation involving the right and left lobes was observed in 4 patients.

The team observed lymphadenopathy in 12% of patients, and none of the patients had hepatocellular carcinoma.

There was no significant overall association between fibrosis grade and MELD score.

Dr Semelka's team concluded, “Although fibrosis is a common feature in autoimmune hepatitis and is often moderate to severe.”

“No significant correlation between fibrosis grade and MELD score was found.”

Radiol 2005: 236: 896-902
26 August 2005

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