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Segmental difference of the hepatic fibrosis from chronic viral hepatitis due to hepatitis B versus C virus infection: comparison using dual contrast material-enhanced MRI.

 Jae Ho Shim, MD  ;  Jeong-Sik Yu, MD  ;  Jae-Joon Chung, MD  ;  Joo Hee Kim, MD  ;  Ki Whang Kim, MD 
 KOREAN JOURNAL OF RADIOLOGY, Vol.12(4) : 431-438, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Contrast Media* ; Dextrans* ; Diagnosis, Differential ; Female ; Gadolinium DTPA* ; Hepatitis B, Chronic/diagnosis* ; Hepatitis C, Chronic/diagnosis* ; Humans ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/virology* ; Magnetite Nanoparticles* ; Male ; Middle Aged ; Retrospective Studies ; Statistics, Nonparametric
Chronic hepatitis B ; Chronic hepatitis C ; Gadolinium ; Iron ; Liver cirrhosis ; Magnetic resonance imaging
OBJECTIVE: We wanted to identify the geographic differences in hepatic fibrosis and their associations with the atrophy-hypertrophy complex in patients with chronic viral hepatitis using the dual-contrast material-enhanced MRI (DC-MRI) with gadopentetate dimeglumine and ferucarbotran. MATERIALS AND METHODS: Patients with chronic C (n = 22) and B-viral hepatitis (n = 35) were enrolled for determining the subjective grade of fibrosis (the extent and thickness of fibrotic reticulations) in the right lobe (RL), the caudate lobe (CL), the medial segment (MS) and the lateral segment (LS) of the liver, with using a 5-grade scale, on the gradient echo T2(*)-weighted images of DC-MRI. The fibrosis grades of different segments were compared using the Kruskal-Wallis test followed by post-hoc analysis to establish the segment-by-segment differences. The incidences of two pre-established morphologic signs of cirrhosis were also compared with each other between the two groups of patients. RESULTS: There were significant intersegmental differences in fibrosis grades of the C-viral group (p = 0.005), and the CL showed lower fibrosis grades as compared with the grades of the RL and MS, whereas all lobes were similarly affected in the B-viral group (p = 0.221). The presence of a right posterior hepatic notch was significantly higher in the patients with intersegmental differences of fibrosis between the RL and the CL (19 out of 25, 76%) than those without such differences (6 out of 32, 19%) (p < 0.001). An expanded gallbladder fossa showed no significant relationship (p = 0.327) with the segmental difference of the fibrosis grades between the LS and the MS. CONCLUSION: The relative lack of fibrosis in the CL with more advanced fibrosis in the RL can be a distinguishing feature to differentiate chronic C-viral hepatitis from chronic B-viral hepatitis and this is closely related to the presence of a right posterior hepatic notch
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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