Autoimmune hepatitis: CT and MR imaging features with histopathological correlation

Area of Science:

• Radiology
• Hepatology
• Immunology

Background:

• Autoimmune hepatitis (AIH) is a chronic liver disease characterized by immune-mediated hepatocyte damage.
• Accurate diagnosis and staging of AIH are crucial for effective management and prognosis.
• Imaging plays a role in assessing liver morphology and disease progression in AIH.

Purpose of the Study:

• To characterize computed tomography (CT) and magnetic resonance (MR) imaging findings in patients with autoimmune hepatitis (AIH).
• To correlate imaging features with histological grade and stage of AIH.
• To describe imaging changes observed during treatment for AIH.

Main Methods:

• Retrospective analysis of initial CT (n=22) and MRI (n=12) scans from 27 pathologically-proven AIH patients.
• Evaluation of objective and subjective imaging features, correlating them with histological inflammatory grade and fibrotic stage.
• Serial imaging during treatment was assessed in eight patients.

Main Results:

• Significant positive correlations were found between ascites, expanded gallbladder fossa, spleen size, enlarged preportal space, and fibrotic stage.
• No significant correlations were observed between imaging features and inflammatory grade.
• Surface nodularity was the most common abnormal finding (CT: 50%, MRI: 66.7%); 25.9% of patients had normal initial scans.

Conclusions:

• CT and MR imaging demonstrate a broad spectrum of features in AIH.
• Specific MRI findings show a significant positive correlation with the fibrotic stage of AIH, aiding in non-invasive assessment.