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

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; me...

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Bibliographic Details
Published in:	European radiology Vol. 30; no. 1; pp. 213 - 223
Main Authors:	Chouraqui, Esther, Leguilloux, Laura, Dohan, Anthony, Gouya, Hervé, Barral, Matthias, Vallet-Pichard, Anais, Sogni, Philippe, Pol, Stanislas, Mallet, Vincent, Soyer, Philippe
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 2020 Springer Nature B.V
Subjects:	Accuracy Adult Age Case-Control Studies Cirrhosis Confidence intervals Contours Control methods Diagnosis Diagnostic Radiology Familiarity Female Hepatobiliary-Pancreas HIV HIV Infections - complications Human immunodeficiency virus Humans Imaging Independent variables Internal Medicine Interventional Radiology Liver Liver cirrhosis Liver Cirrhosis - diagnostic imaging Liver Diseases - diagnostic imaging Liver Diseases - pathology Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical imaging Medicine Medicine & Public Health Middle Aged Multivariate Analysis Neuroradiology NMR Nuclear magnetic resonance Radiology Retrospective Studies Ultrasound Magnetic resonance imaging (MRI) Portal system HIV Hypertension, Portal
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0938-7994 1432-1084
DOI:	10.1007/s00330-019-06391-6