HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brancatelli, G. Articles by Pealer, K. Search for Related Content PubMed PubMed Citation Articles by Brancatelli, G. Articles by Pealer, K. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Focal Confluent Fibrosis in Cirrhotic Liver: Natural History Studied with Serial CT

¹ Istituto di Radiologia, Università di Palermo, Via Villaermosa 29, 90139 Palermo, Italy.
² Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
³ Department of Radiology, University of Chicago, Chicago, IL.
⁴ Present address: Department of Radiology, Stanford University Medical Center, Stanford, CA.

OBJECTIVE. The objective of this study was to assess the long-term natural history of focal confluent fibrosis in cirrhotic liver with CT.

MATERIALS AND METHODS. Two radiologists retrospectively reviewed in consensus 118 liver CT examinations in 26 patients (19 men, seven women; age range, 32–68 years; mean age, 50 years) performed over approximately 6 years. Helical CT scans were obtained before and 30–35 and 65–70 seconds after injection of 125–150 mL of contrast medium at a rate of 4–5 mL/s. Proof of cirrhosis was based on liver transplantation (n = 6), biopsy (n = 9), or imaging findings (n = 11). The number, location, and attenuation of fibrotic lesions and presence of trapped vessels were evaluated. Variation of hepatic retraction associated with the development of focal confluent fibrosis lesions was assessed using the ellipsoid volume formula and an arbitrary retraction index.

RESULTS. Each radiologist identified 41 focal confluent fibrosis lesions. All lesions were identified by both radiologists. Twelve patients (46%) had a single lesion, 13 (50%) had two lesions, and one (4%) had three lesions. Thirty-four (83%) of 41 lesions were located in segment IV, VII, or VIII. Thirty-two lesions (78%) were hypoattenuating on unenhanced images, 25 lesions (61%) were hypoattenuating on hepatic arterial phase images, and 20 lesions (49%) were isoattenuating on portal venous phase images. Seven lesions (17%) were or became hyperattenuating at follow-up on portal venous phase images. Trapped vessels were found in six lesions (15%). The retraction index showed a significant increase over time (r = 0.423, p 0.0001).

CONCLUSION. The degree of capsule retraction associated with focal confluent fibrosis evolves with time and relates to the natural evolution of cirrhosis.

Keywords: cirrhosis • CT • liver • liver fibrosis

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?