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

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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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

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Funding

This research received no financial support.

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Authors and Affiliations

  1. Department of Body and Interventional Imaging, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France

    Esther Chouraqui, Anthony Dohan, Hervé Gouya, Matthias Barral & Philippe Soyer

  2. Department of Hepatology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France

    Laura Leguilloux, Anais Vallet-Pichard, Philippe Sogni, Stanislas Pol & Vincent Mallet

  3. Université Paris 5-Descartes, rue de l’Ecole de Médecine, 75006, Paris, France

    Anthony Dohan, Matthias Barral, Philippe Sogni, Stanislas Pol, Vincent Mallet & Philippe Soyer

  4. INSERM U1275, Carcinose Péritoine et Paris-Technologie, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France

    Anthony Dohan, Matthias Barral & Philippe Soyer

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  1. Esther Chouraqui
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  10. Philippe Soyer
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Correspondence to Philippe Soyer.

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Chouraqui, E., Leguilloux, L., Dohan, A. et al. Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?. Eur Radiol 30, 213–223 (2020). https://doi.org/10.1007/s00330-019-06391-6

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