Confluent hepatic fibrosis in advanced cirrhosis: evaluation with MR imaging

To assess the usefulness of magnetic resonance (MR) imaging in diagnosis of confluent fibrosis in patients with advanced cirrhosis.

Findings on pretransplantation MR images were compared with findings on pretransplantation computed tomographic (CT) scans and posttransplantation gross appearance and histologic findings in 11 patients with confluent fibrosis. In all patients, MR imaging was performed before and after administration of gadopentetate dimeglumine.

Nine lesions appeared wedge shaped and involved the medial segment of the left lobe, anterior segment of the right lobe, or both; two lesions consisted entirely of lobar or segmental fibrosis. Associated volume loss in the affected regions was seen in 10 lesions. All 11 lesions were hypoattenuating on non-contrast material-enhanced CT scans.

Findings on MR images corresponded well to CT findings and gross appearance. MR imaging provided useful morphologic information about confluent fibrosis, but the MR signal characteristics are not unique and do not enable differentiation from hepatic neoplasms.