Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?
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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.
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.
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.
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.
• 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.
KeywordsMagnetic resonance imaging (MRI) Hypertension, Portal Portal system HIV
- 3D VIBE
Three-dimensional volumetric interpolated breath-hold gradient-echo
Area under the curve
Caudate-to-right lobe ratio
Focal nodular hyperplasia
T2-weighted half-Fourier acquisition single-shot turbo spin-echo
Human immunodeficiency virus
Magnetic resonance imaging
Picture archiving and communication system
Receiving operative curve
This research received no financial support.
Compliance with ethical standards
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.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• diagnostic study
• performed at one institution
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