Primary biliary cirrhosis (PBC) is a major cause of liver disease. Dr Arye Blachar and colleagues reviewed the clinical, pathological and CT scan findings in 53 patients, who later underwent orthotopic liver transplantation due to PBC.
All 53 patients underwent helical multiphase computed tomographic (CT) scans. The number of scans per patient ranged from one to five.
The research team evaluated epidemiological, clinical and morphological features in advanced and less advanced primary biliary cirrhosis.
Advanced PBC was defined as hepatic insufficiency, requiring liver transplantation within two years.
For all 53 patients the average time from diagnosis to liver transplantation was 6.1 years.
|CT can demonstrate varices and ascites before clinical cirrhosis is evident.
45 of the 53 patients (85%) were women who had been diagnosed with PBC in middle age.
The research team described the CT scan findings in patients with advanced or less advanced disease.
CT scans of patients with advanced PBC were similar to those seen in other forms of cirrhosis. Livers were generally small and heterogeneously attenuating. Varices and splenomegaly were often apparent.
In less advanced PBC, CT scans showed a liver that was normal or enlarged in size, with a smooth contour and little atrophy. Regenerative nodules and lacelike fibrosis appeared in around 30% of scans of less advanced PBC.
CT scans demonstrated varices in 62% and ascites in 24% of patients with less advanced PBC.
After a mean follow-up period of 42 months following liver transplantation, recurrence of PBC occurred in only 2 patients.
Dr Blachar concludes, "PBC is an important cause of liver failure, with distinctive clinical and CT findings that may assist diagnosis and allow adequate treatment."