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Diagnostic utility of radiological heterogeneity in acute severe (fulminant) autoimmune hepatitis
Author(s) -
Fujiwara Keiichi,
Yasui Shin,
Yokosuka Osamu,
Oda Shigeto,
Kato Naoya
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.487
Subject(s) - medicine , fulminant , autoimmune hepatitis , ascites , radiological weapon , radiology , fulminant hepatitis , fulminant hepatic failure , liver biopsy , computed tomography , gastroenterology , biopsy , hepatitis , liver transplantation , transplantation
Abstract Background Histological examination is useful for the diagnosis of acute severe (fulminant) autoimmune hepatitis ( AIH ), but it is sometimes difficult to perform liver biopsy due to the complicated coagulopathy and ascites. We have shown that heterogeneous hypoattenuation on unenhanced computed tomography ( CT ) is a characteristic imaging feature of acute severe (fulminant) AIH . In the present study, we examined the utility of the imaging feature by applying the score to diagnose acute severe (fulminant) AIH . Methods Twenty‐three patients with acute severe (fulminant) AIH were analyzed retrospectively. Modified AIH score was created by adding three points to AIH score with/without histological points in case of the presence of heterogeneous hypoattenuation on unenhanced CT . Results Areas of hypoattenuation were present in 15 (65%) patients, all of which were heterogeneous pattern. Five (22%) patients were diagnosed as “definite” AIH , 16 (69%) as “probable” and two (9%) as “non‐diagnosis” by the revised original score without histological score. By adding three points, two of “non‐diagnosis” changed to “probable” AIH , and all patients were diagnosed as AIH . Conclusions Modified AIH score using heterogeneous CT image finding would be beneficial especially for patients in whom histological examinations cannot be performed because of complications.