Utility of ECG-gated MDCT to differentiate patients with ARVC/D from patients with ventricular tachyarrhythmias

BackgroundThe accuracy of electrocardiogram-gated CT for diagnosing arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is uncertain.ObjectiveWe propose a comprehensive system for scoring characteristic CT findings to diagnose ARVC/D and discuss its utility.MethodsSeventy-seven patients (mean age, 43.1 years; 48 male) diagnosed with ARVC/D or with suspected ARVC/D on the basis of ventricular tachyarrhythmias underwent CT with and without contrast enhancement. We retrospectively graded characteristic CT findings (fatty tissue, bulging appearance, and dilatation of the right ventricle) as minor (1 point) or major (2 points) and then validated our scoring system’s utility for diagnosing ARVC/D with the use of the modified 2010 Task Force criteria as the reference standard.ResultsWe diagnosed 27 of 77 patients with ARVC/D (23 definite, 4 borderline), observing each CT finding more often in patients with ARVC/D than in patients without ARVC/D: fatty tissue, 74.1% versus 12.0%; bulging appearance, 74.1% versus 34.0%; and RV dilatation, 92.6% versus 44.0%. However, observation of each finding in both groups could cause false positive diagnosis. Recursive partitioning analysis showed the superiority of our CT scoring system over methods that used each CT finding and CT findings without fatty tissue for distinguishing ARVC/D and non-ARVC/D. For overall (definite and borderline) and definite ARVC/D diagnosis, sensitivities were 77.8% and 87.0%, specificities were 96.0% and 94.4%, positive predictive values were 91.3% and 87.0%, negative predictive values were 88.9% and 94.4%, and accuracies were 89.6% and 92.2%, respectively.ConclusionsOur CT scoring system showed excellent diagnostic ability and might aid differentiation of ARVC/D from ventricular tachyarrhythmias.     

Quantitative assessment of right ventricular structural abnormalities by right ventricular polar mapping of single photon emission computed tomogram

The identification of right ventricular (RV) abnormalities is clinically important in the evaluation of arrhythmogenic substrates in right ventricular-originated ventricular tachycardia (RVT). The purpose of this study was to determine the diagnostic benefit of quantitative analysis in RV single photon emission computed tomography (SPECT) imaging with (99m)Tc-tetrofosmin/sestamibi in patients with RVT. Thirty patients with RVT (15 with idiopathic RVT and 15 with arrhythmogenic right ventricular cardiomyopathy (ARVC)) were compared with 27 control subjects (including 11 with right bundle branch block) with regard to the semiquantitative RV uptake score in each of six segments and the quantitative RV extent score in polar coordinate map displays by SPECT imaging. The RV total score and RV extent score were compared with the RV global function. Perfusion abnormalities were more frequently detected (P = 0.0001) in the ARVC group (59/90, 65.6%) than in the idiopathic RVT group (4/90, 4.4%) or controls (1/162, 0.6%). The RV extent score in the ARVC group (53.0 +/- 24.8) was significantly higher than that in the idiopathic RVT group (8.4 +/- 10.1) or controls (1.2 +/- 4.9). The RV extent score correlated well with the regional RV perfusion score (P < 0.0001) and with the RV ejection fraction (P < 0.0001). Non-invasive RV perfusion mapping using a (99m)Tc-labelled tracer is useful for the quantitative evaluation of RV substrates in patients with ARVC.     

致心律不齐性右室心肌病的MRI诊断

目的：用心脏MR新技术评价致心律不齐性右室心肌病（ARVC）的MRI征象，探讨MR扫描技术。方法：对15例临床、超声诊断或疑为ARVC的病人进行RM检查，使用GE Signa1.5TCV/iMR扫描系统，扫描序列包括黑血技术：双反转恢复快速自旋回波(double-IR FSE)和三反转自旋回波（triple-IR FSE）序列；白血技术：快速电影成像（fastcine）序列。扫描平面有短轴面、四腔面和长轴面。结果：10例诊断为ARVC，ARVC的主要MRI表现有：右室壁脂肪信号3例，右室壁变薄9例，右心室扩大6例，室壁瘤形成2例，右心腔内慢血流信号9例，右室射血分数降低6例，右房扩大3例。右室乳状肌和左室心尖部、室间隔前部累及2例。黑血技术可显示心脏解剖、形态及组织特性，白血技术主要了解心脏功能及心肌壁的运动，短轴面和四腔面显示病变较满意。结论：ARVC的RMI表现具有一定的特征，多序列、多平面成像的MR新技术对该病的诊断更准确、更可靠。     

Assessment of inflammation in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia

Purpose  

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a myocardial disease that predominantly affects the right ventricle (RV). Its hallmark feature is fibro-fatty replacement of RV myocardium. However, patchy inflammatory infiltrates in the RV are also consistently reported using autopsy and myocardial biopsy. Although the role of inflammation in ARVC/D is unresolved, the ability to assess inflammation non-invasively may aid in the diagnostic process. We aimed to establish whether cardiac inflammation can be assessed non-invasively in ARVC/D patients.     

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

Objective The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Materials and methods Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks’ duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Results Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Conclusion Radiographs should not be obtained routinely when MRI is being performed in young adults with non-acute knee complaints because the yield and added value to MRI are low.     

Symmetrical central tegmental tract (CTT) hyperintense lesions on magnetic resonance imaging in children

The central tegmental tract (CTT) is mainly the extrapyramidal tract connecting between the red nucleus and the inferior olivary nucleus. There are only a few case reports describing CTT abnormalities on magnetic resonance imaging (MRI) in children. Our purpose was to evaluate the frequency of CTT lesions and their characteristics on MRI, and to correlate the MR imaging findings with clinical features. We reviewed retrospectively the MR images of 392 children (215 boys and 177 girls) ranging in age from 1 to 6 years. To evaluate symmetrical CTT hyperintense lesions, we defined a CTT lesion as an area of bilateral symmetrical hyperintensity in the tegmentum pontis on both T2-weighted images and diffusion-weighted images in more than two slices. We measured the ADC (apparent diffusion coefficient) values of symmetrical CTT hyperintensity, and compared them with those of children without CTT abnormality. CTT lesions were detected in 20 (5.1%) of the 392 children. The mean ADC value for these 20 children was significantly lower than that of the normal CTT (p < 0.001). On MR imaging, other than CTT lesions, associated parenchymal lesion included: none (n = 6); other abnormalities, including periventricular leukomalacia (n = 3); thin corpus callosum (n = 3); ventricular dilatation (n = 2); encephalopathy (n = 2). Clinically, cerebral palsy was the most frequent clinical diagnosis (n = 6), accounting for 30%, which was significantly more frequent than the prevalence of cerebral palsy among children without CTT lesions (13%) (n < 0.05). CTT lesions were detected in 5.1% of all the children examined. Cerebral palsy was the most frequent clinical diagnosis.     

Diagnostic work up of arrhythmogenic right ventricular cardiomyopathy by cardiovascular magnetic resonance (CMR). Consensus statement

Cardiovascular Magnetic Resonance (CMR) has become a widespread diagnostic tool. Since its introduction CMR has been used to image patients with known or suspected arrhythmogenic right ventricular cardiomyopathy (ARVC). Several abnormalities have been found and described by CMR and at present this diagnostic tool is considered very important for the diagnosis. However, the diagnosis of ARVC relies upon the fulfillment of both clinical and functional criteria and CMR can provide several but not all the information useful for the diagnosis. Furthermore, some findings such as evidence of right ventricular epicardial fat once considered a peculiar marker of ARVC, have been shown to possess a low specificity. This document was prepared by representatives of the three Italian official Organizations involved in CMR. Its main scope is to highlight the problems encountered when studying patients with suspected ARVC by CMR, to indicate the basic technical equipment needed, to recommend a proper imaging protocol and to offer a consensus on the main diagnostic features relevant for the diagnosis.     

Severity assessment of acute pulmonary embolism: evaluation using helical CT

The objective was to evaluate the helical CT (HCT) criteria that could indicate severe pulmonary embolism (PE). In a retrospective study, 81 patients (mean age 62 years) with clinical suspicion of PE explored by HCT were studied. The patients were separated into three different groups according to clinical severity and treatment decisions: group SPE included patients with severe PE based on clinical data who were treated by fibrinolysis or embolectomy (n=20); group NSPE included patients with non-severe PE who received heparin (n=30); and group WPE included patients without PE (n=31). For each patient we calculated a vascular obstruction index based on the site of obstruction and the degree of occlusion in the pulmonary artery. We noted the HCT signs, i.e., cardiac and pulmonary artery dimensions, that could indicate acute cor pulmonale. According to multivariate analysis, factors significantly correlated with the severity of PE were: the vascular obstruction index (group SPE: 54%; group NSPE: 24%; p<0.001); the maximum minor axis of the left ventricle (group SPE: 30.2 mm; group NSPE: 40.4 mm; p<0.001); the diameter of the central pulmonary artery (group SPE: 32.4 mm; group NSPE: 28.3 mm; p<0.001); the maximum minor axis of the right ventricle (group SPE: 47.5 mm; group NSPE: 42.7 mm; p=0.029); the right ventricle/left ventricle minor axis ratio (group SPE: 1.63; group NSPE: 1.09; p<0.0001). Our data suggest that hemodynamic severity of PE can be assessed on HCT scans by measuring four main criteria: the vascular obstruction index; the minimum diameter of the left ventricle; the RV:LV ratio; and the diameter of the central pulmonary artery.     

一氧化碳中毒迟发性脑病脑电图及磁共振成像影像学应用

目的 探讨急性一氧化碳中毒(ACMP)并发迟发性脑病(DEACMP)的脑电图(EEG)及磁共振成像(MRI)影像学的诊断价值.方法 选取2015年至2018年来三门峡市中心医院收治的符合纳入标准及排除标准的375例急性一氧化碳中毒患者为研究对象,收集研究对象的完整临床资料,对研究对象出院后进行3个月以上的随访,根据是否...     

Right ventricular outflow tract obstruction as a confounding factor in the assessment of the impact of pulmonary regurgitation on the right ventricular size and function in patients after repair of tetralogy of Fallot

Purpose:

To compare right ventricular (RV) size and function between patients with combined pulmonary regurgitation (PR) plus RV outflow tract (RVOT) obstruction (RVOTO) and patients with isolated PR.

Materials and Methods:

Consecutive individuals with significant PR (PR fraction ≥20%) after tetralogy of Fallot (TOF) repair who underwent cardiovascular magnetic resonance (CMR) were included. Patients with additional hemodynamic abnormalities (residual ventricular septal defect, extracardiac shunt, and/or more than mild regurgitation at a valve other than the pulmonary valve) were excluded. Significant RVOTO was defined as peak gradient across RVOT ≥30 mmHg.

Results:

Significant differences between patients with combined PR+RVOTO (n = 9) and isolated PR (n = 33) were observed in RV end‐diastolic volume (138.6 ± 25.1 vs. 167.0 ± 34.6 mL/m², P = 0.02, respectively), RV end‐systolic volume (65.0 ± 9.6 vs. 92.7 ± 26.2 mL/m², P = 0.003), and RV ejection fraction (RVEF) (52.8 ± 3.7 vs. 45.0 ± 6.4%, P = 0.001). Both PR and peak RVOT gradient were independent predictors of RV size.

Conclusion:

Patients with combined PR+RVOTO had smaller RV volumes and higher RVEF when compared with patients with isolated PR. The confounding effect of RVOTO on RV size and function needs to be considered in CMR studies evaluating patients after TOF repair. J. Magn. Reson. Imaging 2011;33:1040–1046. © 2011 Wiley‐Liss, Inc.     

Spinal cord magnetic resonance imaging in suspected multiple sclerosis

We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved. Received: 21 April 1999; Revised: 3 August 1999; Accepted: 7 August 1999     

Imaging of programmed cell death in arrhythmogenic right ventricle cardiomyopathy/dysplasia

Background  

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a myocardial disease that predominantly affects the right ventricle (RV). Its hallmark feature is fibrofatty replacement of the RV myocardium. Apoptosis in ARVC/D has been proposed as an important process that mediates the slow, ongoing loss of heart muscle cells which is followed by ventricular dysfunction. We aimed to establish whether cardiac apoptosis can be assessed noninvasively in patients with ARVC/D.     

Phace Syndrome in Children: Two Case Reports

PHACE(S) syndrome combines: posterior fossa brain malformations, face hemangioma, arterial cerebrovascular abnormalities, cardiovascular abnormalities, eye abnormalities, and ventral developmental defects (Sternal defects or supra-umbilical rope). The diagnosis is based on the association of an infant hemangioma exceeding 5cm in size on the face, neck, scalp with 1 major criteria or 2 minor criteria. Imaging, especially Gadolinium MRI and MRA of the brain, neck, and aortic arch, transthoracic echocardiography, or even cardiac MRI play a key role in the detection of associated neurological and cardiovascular abnormalities.We report 2 cases of PHACE syndrome revealed by 2 different clinical presentations.     

MRI assessment of right ventricular dysplasia

Right ventricular dysplasia is a new entity of unknown origin in the classification of cardiomyopathies. Also known as arrhythmogenic right ventricular cardiomyopathy (ARVC) or arrhythmogenic right ventricular dysplasia, it is a disease of the heart muscle characterised by fibroadipose atrophy mainly involving the right ventricle and responsible for severe ventricular arrhythmias and sudden death also in young people. Magnetic resonance imaging provides evidence of ventricular dilatation at the outflow tract, thinning and thickening of the wall, diastolic bulging areas (especially located at the level of the right ventricle outflow tract) and fatty substitution of the myocardium mainly at the level of the right ventricle. Many radiologists erroneously consider the previously described fatty substitution as the main sign of ARVC, even though an evaluation of fat substitution alone may be a source of error for two reasons: firstly, because isolated areas of fatty replacement are not synonymous with ARVC since small non-transmural focal fatty areas of fat are also present in the normal patients; and secondly, because the MRI detection of fat may be overestimated due to partial-volume artefacts with normal subepicardial fat. Cardiac MRI can also be employed for the diagnosis of idiopathic right ventricular outflow tract tachycardia. Considering the evolutive nature of the disease, the non-invasiveness of MRI allows the follow-up of these patients and may be considered an excellent screening modality for the diagnosis of ARVC in family members. Finally, MRI can be employed in electrophysiological studies to locate the arrhythmogenic focus and reduce sampling errors. Electronic Publication     

Right ventricle shape and contraction patterns and relation to magnetic resonance imaging findings

OBJECTIVE: To analyze and to describe the shape and contraction of the normal right ventricle (RV) as visualized by magnetic resonance imaging (MRI). METHODS: Thirty normal volunteers were imaged using cine MRI in axial, short-axis, and long-axis planes. The shape and contraction of the RV were qualitatively evaluated. Quantitative evaluation of RV shape was performed by calculating the angle subtended between the planes of horizontal long-axis view (HLA) and axial view and the RV base-to-apex distance. Multiplanar reformation was used to visualize changes between corresponding views. RESULTS: The spectrum of major RV shape (wedge, box, and round) was more variable on axial images (17%, 43%, and 23%, respectively) than on HLA images (63%, 20%, and 0%, respectively). Focal outpouching of the RV free wall was more frequent on the axial view than on the HLA view. The subtended plane angle and base-to-apex distance showed statistically significant dependence indicative of an artificially foreshortened RV in the axial view with a direct influence on RV variations. CONCLUSIONS: With increasing subtended angles, variation of the normal RV appearance is substantially higher on axial views compared with HLA views.     

MRI findings of prolonged post-traumatic sternal pain

Objective The objective of this study was to characterize the different causes of prolonged sternal pain following thoracic trauma with involvement of the sternum and to define criteria for sternal nonunion diagnosis using MRI. Design and patients Five patients with abnormalities of the sternum were evaluated for prolonged sternal pain following thoracic trauma using MRI. MR images were evaluated by two radiologists in consensus. The patients were selected from the radiology database, which included 8 patients with post-traumatic prolonged sternal pain. Results Two patients (n = 2) revealed a sternal nonunion after sternal fracture. One patient had a sternal fracture with delayed union and minor displacement of the sternal halves. Abnormal signal intensity alterations adjacent to and within the manubrio-sternal joint were evident in 2 patients and considered due to trauma-related changes in the manubrio-sternal joint. The 3 patients who were not included in the study had no abnormalities of the sternum: 1 of them proved to have a well-healed sternal fracture and nonunion of a rib fracture, 1 had subtle Tietze’s syndrome, and 1 patient revealed no pathological findings on imaging. Conclusion Various factors may be responsible for prolonged sternal pain following thoracic trauma, and these can be viewed with MRI. In cases of sternal nonunion there was common fluid-like signal in the fracture interspace between the bony edges, and the bone marrow adjacent to the nonunion showed altered signal intensity. MRI identified sternal nonunion and other trauma-related abnormalities of the sternum following chest trauma.     

心内膜心肌纤维化症的MRI诊断

目的评价ＭＲＩ对心内膜心肌纤维化症（ＥＭＦ）的诊断价值和限度。材料与方法对９例经影像学（包括超声心动图、心导管、Ｘ线心血管造影以及放射性核素显像）诊断、或（和）病理证实（５例）的ＥＭＦ患者，行心电图门控心脏自旋回波和梯度回波电影ＭＲＩ扫描。结果ＥＭＦ分为右室型（ＲＶＥＭＦ）、左室型（ＬＶＥＭＦ）和双室型（ＢＶＥＭＦ）三个亚型，ＭＲＩ所见为：（１）右室型（６例）：右室心内膜显著增厚呈较高信号，右室腔缩小变形，流入道短缩，心尖闭塞而流出道扩张，室壁运动减弱，电影ＭＲＩ（３例）显示有中至大量三尖瓣返流。右心房高度扩大，腔静脉亦显著扩张。（２）左室型（１例）：左室心尖圆钝，心内膜凸凹不平、显著增厚，呈“异常肌束”改变，电影ＭＲＩ可见中等量以上的二尖瓣返流，左室壁运动减弱。左心房显著扩大，肺静脉和主肺动脉扩张。（３）双室型（２例）：兼有二心室受累的改变，但以一侧受累为主。其中１例合并右室心尖附壁血栓，表现为Ｔ１ＷＩ球形高信号，Ｔ２ＷＩ为中等度略高信号。结论ＥＭＦ的ＭＲＩ所见具有相当的特征性，ＭＲＩ可以作为确定ＥＭＦ诊断的手段     

Postural and gait performance in children with attention deficit/hyperactivity disorder

Up to 50% of children and adolescents with attention deficit/hyperactivity disorder (ADHD) exhibit motor abnormalities including altered balance. Results from brain imaging studies indicate that these balance deficits could be of cerebellar origin as ADHD children may show atrophy in those regions of the cerebellum associated with gait and balance control. To address this question, this study investigated postural and gait abilities in ADHD children and compared their static and dynamic balance with children with known lesions in the cerebellum. Children diagnosed with ADHD according to DSM IV-TR diagnostic criteria were compared with children with chronic surgical cerebellar lesions and age-matched controls. A movement coordination test was used to assess differences in motor development. Postural and gait abilities were assessed using posturography, treadmill walking and a paced stepping task. Volumes of the cerebellum and the cerebrum were assessed on the basis of 3D magnetic resonance images (MRI). Children with cerebellar lesions showed significant performance decrements in all tasks compared with the controls, particularly in the movement coordination test and paced stepping task. During dynamic posturography ADHD-participants showed mild balance problems which correlated with findings in cerebellar children. ADHD children showed abnormalities in a backward walking task and minor abnormalities in the paced stepping test. They did not differ in treadmill walking from the controls. These findings support the notion that cerebellar dysfunction may contribute to the postural deficits seen in ADHD children. However, the observed abnormalities were minor. It needs to be examined whether balance problems become more pronounced in ADHD children exhibiting more prominent signs of clumsiness.     

Leukoencephalopathy with swelling in children and adolescents: MRI patterns and differential diagnosis

In children, several neurological disorders are characterised by spongiform leukoencephalopathy. MRI of the brain typically shows white matter swelling, but does not enable differentiation of the various underlying disorders. The aim of this article is optimisation of the diagnostic value of MRI in leukoencephalopathy accompanied by swelling. MRI-based inclusion criteria were met by 20 patients in our database. The images were analysed using a detailed scoring list. In 13 of the 20 patients the clinical diagnosis was known (11 definite and 2 probable diagnoses). Characteristic MRI abnormalities could be defined in these patients. Of the 7 patients without a diagnosis, 5 had identical MRI abnormalities: difuse hemisphere swelling and typical cysts in frontoparietal subcortical white matter and the tips of the temporal lobes. The clinical picture was also similar in these patients, suggesting a similar disease.     

Gamna-Gandy bodies in cirrhosis: a meaningless finding?

Purpose

To determine the presence of Gamna-Gandy bodies (GGB) on MRI in patients with liver cirrhosis.

Patients and methods

A total of 117 consecutive patients with cirrhosis followed-up by MRI were retrospectively reviewed. Two groups were defined: the first group included patients with GGB on MRI (n = 15), the other group included patients without GGB (n = 102). Both characteristics of groups were reviewed using standard cirrhosis criteria evaluation: sex, age, etiology of cirrhosis, Child-Pugh score, presence of esophageal varices, splenomegaly, ascitis, recanalization of the periumbilical veins, and presence of hepatic encephalopathy. Fisher's exact test and student t-test were used to compare both groups.

Results

GGB were more frequently observed in patients with splenomegaly (P = 0.035). Hemochromatosis was the only etiology for cirrhosis statistically correlated to the presence of GGB (P = 0.006) in our series. No other statistically significant association was noted between GGB and other characteristics of our cirrhotic patients.

Conclusion

Easily identified on all MRI pulse sequences, GGB do not correlate with the severity of cirrhosis. However, they are strongly correlated with the presence of splenomegaly and may be the result of segmental splenic hypertension. They are frequent in patients with hemochromatosis.