Granulomatous hepatitis: MRI findings

The purpose of this study was to describe the magnetic resonance imaging fi ndings of granulomatous hepatitis on T1-weighted, T2-weighted and postgadol inium images. Eight patients with histopathological diagnosis of granulomat ous hepatitis were evaluated in this study. MRI examinations included preco ntrast T1-weighted breath-hold spoiled gradient echo, breathing independent STIR sequences, and T1-weighted breath-hold spoiled gradient-echo sequence following after i.v. gadolinium administration in arterial, intermediate a nd late phases. Diffuse nodular liver involvement was visualized in all pat ients. Nodules were consistent with granulomas and were 0.5-4.5 cm in diame ter. Caseating granulomas were intermediate and high signal on T2-weighted, low signal on T1-weighted images. They revealed no enhancement in two pati ents, and enhanced in one patient. Noncaseating granulomas revealed interme diate signal on T1, and T2-weighted images and increased enhancement on art erial phase images with persisting enhancement in late phase images. Portal lymph nodes were visible in live patients. Splenomegaly was present in fiv e patients. Granulomatous hepatitis has spectrum of MRI features, to be con sidered in differential diagnosis with other diffuse nodular liver patholog ies. (C) 2001 Elsevier Science Inc. All rights reserved.