COMPENSATED CIRRHOSIS DUE TO VIRAL-HEPATITIS - USING MR-IMAGING TO PREDICT CLINICAL PROGRESSION

OBJECTIVE. The goal of our study was to determine the relative value o f multiple MR features in predicting clinical progression of disease i n patients with compensated cirrhosis. MATERIALS AND METHODS. The MR e xaminations of 23 patients with compensated cirrhosis (Child A) were r etrospectively reviewed independently by two radiologists and correlat ed with clinical progression after follow-up of all patients for more than 12 months each (12-87 months; average, 39 months) by the same exp erienced hepatologist. Clinical progression was defined as an increase of the Child grade or the Pugh score by at least two points (5- to 15 -point scale). In the initial MR study of each patient, the following MR findings were assessed by each radiologist independently: volume in dexes of the spleen and each segment of the liver (based on three-axis measurements), nodular surface, regenerative nodules, ascites, iron o r fat deposition, and varices or collaterals. RESULTS. The volume inde x of the spleen was the most accurate predictor of clinical progressio n (p = .001), the next most accurate was the number of sites of varice s or collaterals (p = .002), and the third most accurate was the ratio of caudate lobe to right lobe volume index (p = .02). Other MR findin gs failed to correlate with clinical progression. CONCLUSION. As revea led on MR imaging, the volume index of the spleen, the severity of var ices, and the volume index ratio of caudate lobe to right lobe can be used to help predict clinical progression of disease in patients with compensated cirrhosis.