Changes in orientation of the major interlobar fissure in chronic liver diseases

The orientation of the major interlobar fissure, as an indicator of right lobar atrophy, was evaluated using axial MR imaging in 64 patients with histologically proven chronic liver diseases. The "interlobar fissure angle" was determined by a line drawn through the middle hepatic vein and inferior vena cava and a horizontal line at the level of hepatic hilus. The angle was significantly smaller in cirrhosis than in either chronic persistent or active hepatitis. A much smaller angle was observed in cirrhosis associated with colonic interposition. The increasing incidence of small "interlobar fissure angle" (less than 30 degrees) was observed to parallel the histological stages from chronic persistent hepatitis to liver cirrhosis. All the cirrhotic patients with colonic interposition and an angle of less than 30 degrees. This simple method is considered useful in the diagnosis of right lobar atrophy and disease severity in chronic liver disease.