Changes in hepatic venous morphology with cirrhosis on MRI

To identify changes in vascular morphology on magnetic resonance imaging (MRI) in patients with cirrhosis and to compare these findings to liver donors.

Patients undergoing liver transplantation with biopsy-proven cirrhosis (n = 74) and liver donor candidates (n = 85) underwent dynamic gadolinium-enhanced 3D MR at 1.5T. Vessel diameters were measured independently by three radiologists and features of cirrhosis were identified and correlated with cirrhosis.

Hepatic veins were smaller in patients with cirrhosis (4.9, 4.5, and 5.0 mm for right, middle, and left vs. 9.9, 7.6, and 8.9 mm in donors, P << 0.001) and were negatively correlated with cirrhosis (P < 0.001). Right hepatic vein (RHV) <5 mm diagnosed cirrhosis with 59% sensitivity and 99% specificity; the sensitivity and specificity were 88% and 85% for RHV <7 mm. Main portal vein was minimally larger in cirrhosis, 14 versus 12 mm (P < 0.001) in donors. Right portal veins were smaller in cirrhotic patients, 6.5 and 6.2 mm compared to 8.4 and 7.6 mm (P << 0.001), respectively, in donors.

Vascular features of cirrhosis include small hepatic veins, minimally enlarged main portal vein, and small intrahepatic portal veins; these features may facilitate identification of cirrhosis.