Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?

Esther Chouraqui; Laura Leguilloux; Anthony Dohan; Hervé Gouya; Matthias Barral; Anais Vallet-Pichard; Philippe Sogni; Stanislas Pol; Vincent Mallet; Philippe Soyer

doi:10.1007/s00330-019-06391-6

Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?

Eur Radiol. 2020 Jan;30(1):213-223. doi: 10.1007/s00330-019-06391-6. Epub 2019 Aug 13.

Authors

Esther Chouraqui¹, Laura Leguilloux², Anthony Dohan^{1

3

4}, Hervé Gouya¹, Matthias Barral^{1

3

4}, Anais Vallet-Pichard², Philippe Sogni^{2

3}, Stanislas Pol^{2

3}, Vincent Mallet^{2

3}, Philippe Soyer^{5

6

7}

Affiliations

¹ Department of Body and Interventional Imaging, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
² Department of Hepatology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
³ Université Paris 5-Descartes, rue de l'Ecole de Médecine, 75006, Paris, France.
⁴ INSERM U1275, Carcinose Péritoine et Paris-Technologie, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France.
⁵ Department of Body and Interventional Imaging, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France. philippe.soyer@aphp.fr.
⁶ Université Paris 5-Descartes, rue de l'Ecole de Médecine, 75006, Paris, France. philippe.soyer@aphp.fr.
⁷ INSERM U1275, Carcinose Péritoine et Paris-Technologie, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France. philippe.soyer@aphp.fr.

PMID: 31410601
DOI: 10.1007/s00330-019-06391-6

Abstract

Aim: To describe the magnetic resonance imaging (MRI) features of HIV-associated obliterative portopathy (HIV-OP) and determine the most indicative appearance of this condition on MRI by using a retrospective case-control study.

Methods: MRI examinations of 24 patients with HIV-OP (16 men, 8 women; mean age = 48 ± 6.6 [SD] years; age range, 35-71 years) were analyzed by two blinded observers and compared with those obtained in 18 HIV-infected patients with hepatic cirrhosis (14 men, 4 women; mean age = 51 ± 3.4 [SD] years; age range, 35-60 years). Images were qualitatively and quantitatively analyzed with respect to imaging presentation. Comparisons were performed using uni- and multivariate analyses.

Results: Regular liver contours had the highest accuracy for the diagnosis of HIV-OP (83%, 35 of 42; 95% confidence interval [CI], 69-93%) and was the most discriminating independent variable for the diagnosis of HIV-OP (odds ratio, 51; 95%CI, 4.96-1272%) (p < 0.0001). At multivariate analysis, the width of segment 4 in millimeters (OR = 1.23 [95%CI, 1.05-1.44%]; p = 0.011) and the presence of regular liver contours (OR = 7.69 [95%CI, 1.48-39.92%]; p = 0.015) were the variables independently associated with the diagnosis of HIV-OP.

Conclusions: Regular liver contours are the most discriminating independent variable for the diagnosis of HIV-OP but have limited accuracy. Familiarity with this finding may help differentiate HIV-OP from cirrhosis in HIV-infected patients.

Key points: • Regular liver contour is the most discriminating independent variable for the diagnosis of HIV-OP (odds ratio = 51) with 83% accuracy. • At multivariate analysis, the width of segment 4 in millimeters and the presence of regular liver contours are the variables independently associated with the diagnosis of HIV-OP. • MRI helps diagnose HIV-OP in the presence of several categorical findings, which are more frequently observed in HIV-OP patients than in HIV patients with cirrhosis.

Keywords: HIV; Hypertension, Portal; Magnetic resonance imaging (MRI); Portal system.

MeSH terms

Adult
Case-Control Studies
Female
HIV Infections / complications*
Humans
Liver Cirrhosis / diagnostic imaging
Liver Diseases / diagnostic imaging*
Liver Diseases / pathology
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Multivariate Analysis
Retrospective Studies