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Hepatoportal sclerosis: CT and MRI appearance with histopathologic correlation
Pranay Krishnan1, M Isabel Fiel, Andrew B Rosenkrantz
1Department of Radiology, Mount Sinai Medical Center, 1 Gustave L. Levy Pl, Box 1234, New York, NY 10029, USA.
AJR. American Journal of Roentgenology
|January 24, 2012
Summary
Hepatoportal sclerosis imaging shows caudate lobe hypertrophy and right lobe atrophy. Advanced cases mimic cirrhosis, with nodularity and atrophy, while early stages lack nodularity, distinguishing it from portal hypertension.
Area of Science:
- Radiology
- Hepatology
- Gastroenterology
Background:
- Hepatoportal sclerosis is a rare condition affecting the liver's portal venous system.
- Distinguishing between early and advanced hepatoportal sclerosis on imaging is crucial for patient management.
Purpose of the Study:
- To detail the cross-sectional imaging findings of hepatoportal sclerosis.
- To compare imaging features between advanced and non-advanced hepatoportal sclerosis.
Main Methods:
- Retrospective analysis of 18 patients with pathologically confirmed hepatoportal sclerosis.
- Review of MRI and CT scans assessing liver nodularity, portal vein patency, portal hypertension, liver volume, and caudate-to-right lobe ratio.
- Comparison of imaging features between transplant and non-transplant patients.
Main Results:
- Seventeen of 18 patients showed signs of portal hypertension; 16 had an increased caudate-to-right lobe ratio.
- Liver surface nodularity was present in 5 patients, significantly more common in transplant recipients (p=0.0016).
- Transplant patients had smaller pretransplant liver volumes (p<0.04).
Conclusions:
- Hepatoportal sclerosis typically presents with caudate lobe hypertrophy, right hepatic lobe atrophy, and preserved liver volume.
- Advanced hepatoportal sclerosis can appear similar to cirrhosis on imaging due to nodularity and atrophy.
- Early hepatoportal sclerosis may lack the liver nodularity seen in portal hypertension.
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