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Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?

  • Esther Chouraqui
  • Laura Leguilloux
  • Anthony Dohan
  • Hervé Gouya
  • Matthias Barral
  • Anais Vallet-Pichard
  • Philippe Sogni
  • Stanislas Pol
  • Vincent Mallet
  • Philippe SoyerEmail author
Hepatobiliary-Pancreas
  • 9 Downloads

Abstract

Aim

To describe the magnetic resonance imaging (MRI) features of HIV-associated obliterative portopathy (HIV-OP) and determine the most indicative appearance of this condition on MRI by using a retrospective case-control study.

Methods

MRI examinations of 24 patients with HIV-OP (16 men, 8 women; mean age = 48 ± 6.6 [SD] years; age range, 35–71 years) were analyzed by two blinded observers and compared with those obtained in 18 HIV-infected patients with hepatic cirrhosis (14 men, 4 women; mean age = 51 ± 3.4 [SD] years; age range, 35–60 years). Images were qualitatively and quantitatively analyzed with respect to imaging presentation. Comparisons were performed using uni- and multivariate analyses.

Results

Regular liver contours had the highest accuracy for the diagnosis of HIV-OP (83%, 35 of 42; 95% confidence interval [CI], 69–93%) and was the most discriminating independent variable for the diagnosis of HIV-OP (odds ratio, 51; 95%CI, 4.96–1272%) (p < 0.0001). At multivariate analysis, the width of segment 4 in millimeters (OR = 1.23 [95%CI, 1.05–1.44%]; p = 0.011) and the presence of regular liver contours (OR = 7.69 [95%CI, 1.48–39.92%]; p = 0.015) were the variables independently associated with the diagnosis of HIV-OP.

Conclusions

Regular liver contours are the most discriminating independent variable for the diagnosis of HIV-OP but have limited accuracy. Familiarity with this finding may help differentiate HIV-OP from cirrhosis in HIV-infected patients.

Key Points

• Regular liver contour is the most discriminating independent variable for the diagnosis of HIV-OP (odds ratio = 51) with 83% accuracy.

• At multivariate analysis, the width of segment 4 in millimeters and the presence of regular liver contours are the variables independently associated with the diagnosis of HIV-OP.

• MRI helps diagnose HIV-OP in the presence of several categorical findings, which are more frequently observed in HIV-OP patients than in HIV patients with cirrhosis.

Keywords

Magnetic resonance imaging (MRI) Hypertension, Portal Portal system HIV 

Abbreviations

3D VIBE

Three-dimensional volumetric interpolated breath-hold gradient-echo

AUC

Area under the curve

CI

Confidence interval

CL/RL

Caudate-to-right lobe ratio

CT

Computed tomography

FNH

Focal nodular hyperplasia

HASTE

T2-weighted half-Fourier acquisition single-shot turbo spin-echo

HIV

Human immunodeficiency virus

MRI

Magnetic resonance imaging

OP

Obliterative portopathy

PACS

Picture archiving and communication system

ROC

Receiving operative curve

SD

Standard deviation

SI

Splenic index

TSE

Turbo spin-echo

Notes

Funding

This research received no financial support.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Philippe Soyer.

Conflict of interest

The authors have no conflicts of interest to disclose regarding this study.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic study

• performed at one institution

Supplementary material

330_2019_6391_MOESM1_ESM.doc (52 kb)
ESM 1 (DOC 52 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Esther Chouraqui
    • 1
  • Laura Leguilloux
    • 2
  • Anthony Dohan
    • 1
    • 3
    • 4
  • Hervé Gouya
    • 1
  • Matthias Barral
    • 1
    • 3
    • 4
  • Anais Vallet-Pichard
    • 2
  • Philippe Sogni
    • 2
    • 3
  • Stanislas Pol
    • 2
    • 3
  • Vincent Mallet
    • 2
    • 3
  • Philippe Soyer
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of Body and Interventional ImagingHôpital Cochin, AP-HPParisFrance
  2. 2.Department of HepatologyHôpital Cochin, AP-HPParisFrance
  3. 3.Université Paris 5-DescartesParisFrance
  4. 4.INSERM U1275, Carcinose Péritoine et Paris-TechnologieHôpital LariboisièreParisFrance

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