E4569. Perivenous Hypoenhancement: An Imaging Feature of Alcohol-Related Liver Disease
  1. Lea Chen; Arizona State University
  2. Maria Zulfiqar; Mayo Clinic Arizona
  3. Motoyo Yano; Mayo Clinic Arizona
Determine the proportion of biopsy-proven cases of alcohol-related liver disease which demonstrate perivenous hypoenhancement on CT and/or MRI.

Materials and Methods:
A HIPAA compliant, IRB approved retrospective search of surgical pathology reports over a 4.5-year period using the keywords “alcohol” and “liver” and excluding “alcohol-fixed” and “denies alcohol” yielded 302 reports. Exclusion criteria: specimens not from liver (n=32), duplicate patients (n=2), and lack of contrast-enhanced (CE) CT or MRI within 6 months of the surgical pathology date (n=206), and pathology from a transplant liver (n=5). Two fellowship trained radiologists independently evaluated the images for the presence of perivenous hypoenhancement on CT and MR. CT images were also evaluated for steatosis and MR images were evaluated for steatosis and iron deposition. Steatosis and iron deposition were classified as diffuse, geographic, nodular, or perivenous. Discrepancies were resolved by consensus review.

57 patients were included [41 male (56 years (range 30-75), 16 female (53 years (32-69)]. Most surgical pathology specimens were explant (n=44) with smaller numbers of core needle biopsy (n=12) and partial hepatectomy (n=1). 44 had a clinical history of alcohol use and 13 had histopathology findings which can be seen with alcohol-related liver disease. 61 CE CT (19 patients underwent 1 CT and 14 patients = 2 CT) and 57 MR (31 patients underwent 1 MR and 12 patients = 2 MR) were available for review. 5 CT in 4 patients and 9 MRI in 8 patients demonstrated perivenous hypoenhancement. No exams showed perivenous steatosis, however 1 MR showed iron deposition in a perivenous pattern, potentially contributing to perivenous hypoenhancement. Therefore, 11 of 57 patients (19%) and 13 of 118 (11%) exams showed perivenous hypoenhancement.

Perivenous hypoenhancement is a pattern which may be seen on contrast enhanced CT or MRI in some patients with alcohol-related liver disease. Greater recognition and reporting of this imaging finding may facilitate patient care and future research.