Purpose
Some work reported in literature described the MDCT principal findings of fulminant hepatitis [1-9],
however few authors correlated the imaging findings with the hystopathological examination performed on biopsy or explanted liver [3,
5,
7,
10] and these works are restricted to some particular aspect [5,
7] or have taken into account a small number of cases [3] or are only related to pediatric population [10].
The first aim of our work has been to review CT examinations of adult patients with fulminant hepatic failure of...
Methods and Materials
The MDCT examinations of 11 patients (4 men and 7 women,
median age 44,5 years,
age range 37-67 years),
who underwent OLT due to fulminant hepatic failure between 2003 and 2012 in our liver and multiorgan transplantation department,
were retrospectively evaluated.
These patients were grouped according to the etiology of the acute liver failure: 4 toxic hepatitis (Table 1) (2 from paracetamol,
1 from alcohol and 1 related to drugs used for tuberculosis therapy),
3 hepatitis B,
1 had a mixed etiology by HBV and...
Results
6/11 patients (3/4 with toxic hepatitis and all with vascular etiology) were found to have hepatomegaly through the MDCT examination.
Macroscopic evaluation of the explanted liver confirmed the hepatomegaly in five of them but not in one patient affected by vascular hepatitis.
All patients with hepatitis B and the patient with mixed etiology (HBV + alcohol) had normal or small liver volume according to both MDCT and to pathologic examination.
MDCT scan showed smooth liver contours in all our patients (11/11),
while pathologic examination agreed...
Conclusion
The main histopathologic alterations in fulminant hepatitis are the liver inflammatory cell infiltration and the diffuse hepatocyte necrosis.
The correspondent elements in MDCT examination are: low density liver parenchyma,
periportal low density,
thickened low density gall bladder wall and variations of liver volume.
Regenerative phenomena in the parenchyma could be at the basis of the parenchimal heterogeneous density,
like THAD,
and nodular liver contours.
Other frequent findings are splenomegaly,
ascites and thickened low density colic wall in case of toxic hepatitis.
With the limitations of...
References
Muto,
Y.,
Present status of fulminant hepatitis in Japan (1989-1991). Gastroenterol Jpn,
1993.
28 Suppl 4: p.
120-7.
Sekiyama,
K.,
et al.,
Prognostic value of hepatic volumetry in fulminant hepatic failure. Dig Dis Sci,
1994.
39(2): p.
240-4.
Murakami,
T.,
R.L.
Baron,
and M.S.
Peterson,
Liver necrosis and regeneration after fulminant hepatitis: pathologic correlation with CT and MR findings. Radiology,
1996.
198(1): p.
239-42.
Itai,
Y.,
et al.,
Fulminant hepatic failure: observation with serial CT. Radiology,
1997.
202(2): p.
379-82.
Shakil,
A.O.,
et al.,
Prognostic...
Personal Information
A.
Pecchi,
D.
Corniani,
M.
De Santis,
P.
Torricelli
* Department of Radiology,
University of Modena and Reggio Emilia,
via del Pozzo 71,
41100 Modena,
Italy
[email protected]
[email protected]
[email protected]
L.
Maccio
° Department of Pathology,
University of Modena and Reggio Emilia,
via del Pozzo 71,
41100 Modena,
Italy
N.
De Ruvo,
F.
Di Benedetto
^ Department of Liver and Multiorgan Transplantation,
University of Modena and Reggio Emilia,
via del Pozzo 71,
41100 Modena,
Italy