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Bernard E Van Beers

Publications and source records attributed to Bernard E Van Beers.

18 recordsLinked to original sources
PubMed2007

Assessment of diffusion-weighted MR imaging in liver fibrosis.

PURPOSE: To assess whether hepatic fibrosis is associated with a restriction in the diffusion of water that can be analyzed with diffusion-weighted MR imaging (DWI) of the liver. MATERIALS AND METHODS: DWI was performed in 10 normal rats and 15 rats with liver fibrosis. Echo-planar DWI was performed in the living rats at 1.5 T and repeated immediately after the animals were killed. Afterwards the livers were explanted, fixed in Bouin solution, and imaged with a DW spin-echo sequence at 4.7 T. Fibrosis was quantified by densitometry on Sirius red-stained histological sections. RESULTS: In living rats the apparent diffusion coefficient (ADC) decreased with the severity of liver fibrosis (controls: 1535 +/- 294 mm(2)/second; CCl(4) (5 weeks) 1129 +/- 273 mm(2)/second; CCl(4) (9 weeks): 943 +/- 132 mm(2)/second; P = 0.002). An inverse correlation between ADC and liver fibrosis volume density was observed (r = -0.712, P < 0.001). In contrast, these findings were not observed in the rats after they were killed or in the fixated livers. CONCLUSION: Decreased ADC correlated with increased liver fibrosis in living rats, but not after death. These results suggest that restricted water diffusion cannot be assessed by DWI in liver fibrosis. Other factors, such as a decrease of perfusion, may explain the decrease of the hepatic ADC measured in vivo in rats with liver fibrosis.

Analysis of Variance↗
PubMed2006

Liver fibrosis: non-invasive assessment with MR elastography.

The aim of this study was to assess the feasibility of using non-invasive MR elastography for determining the stage of liver fibrosis. Twenty-five consecutive patients who had liver biopsy for suspicion of chronic liver disease were included in the study. The stage of fibrosis on the biopsies was assessed according to the METAVIR scoring system from F0, no fibrosis, to F4, cirrhosis. MR elastography was performed by transmitting low-frequency (65 Hz) mechanical waves into the liver with a transducer placed at the back of the patients. The MR pulse sequence was a motion-sensitized spin-echo sequence, phase-locked to the mechanical excitation. The phase maps were processed to obtain shear elasticity and shear viscosity maps. The mean hepatic shear elasticity increased with increasing stage of fibrosis. The mean elasticity was 2.24 +/- 0.23 kPa in the 11 patients without substantial fibrosis (F0-F1 grades), 2.56 +/- 0.24 kPa in the four patients with substantial fibrosis (F2-F3) and 4.68 +/- 1.61 kPa in the 10 patients with cirrhosis (F4). The differences between groups were statistically significant (p <or= 0.05). The mean shear viscosity was significantly higher in the patients with cirrhosis (5.19 +/- 1.85 Pa x s) than in the patients without cirrhosis (2.39 +/- 0.86 Pa x s in F0-F1 and 2.27 +/- 0.38 Pa x s in F2-F3 patients). It is concluded that non-invasive MR elastography is a feasible method to assess the stage of liver fibrosis.

Adult↗
PubMed2005

Esophageal varices: evaluation with transesophageal MR imaging--initial experience.

PURPOSE: To prospectively use transesophageal magnetic resonance (MR) imaging to determine the morphologic and hemodynamic characteristics of esophageal varices. MATERIALS AND METHODS: The study was approved by the ethics committee. All patients gave written informed consent. Forty-two patients (29 men, 13 women; mean age, 58 years +/- 11 [standard deviation]) with esophageal varices that were recently demonstrated at endoscopy were included in the study. MR imaging was performed by using a receiver probe that was placed in the esophagus. Black-blood T2-weighted MR images were obtained with cardiac triggering and navigator gating of the right hemidiaphragm. On these images, the maximal diameter, minimal diameter, and surface area of the largest esophageal varix were measured. Periesophageal and paraesophageal varices were recorded. A hemodynamic examination was performed in the last 21 patients to undergo MR imaging, which was used to obtain measurements of flow velocity and rate before and after intravenous injection of 50 mug of octreotide or a placebo. A Kruskal-Wallis test was used to assess differences in the diameter and surface area of the varices according to endoscopic grade. Hemodynamic changes observed after octreotide or placebo injection were compared by using an analysis of variance and a 95% confidence interval. RESULTS: Periesophageal varices were observed in 36 patients, and paraesophageal varices were observed in 32 patients. The minimal diameter, maximal diameter, and surface area of the esophageal varices at MR imaging differed significantly according to endoscopic grade (P < .001). In the periesophageal varices, the velocity and flow changes caused by octreotide differed significantly from those caused by the placebo (P < .001). A decrease in velocity (mean velocity change, -2.766 cm.sec(-1)) and flow (mean flow change, -0.455 mL.sec(-1)) was noted after octreotide injection, but no significant change in velocity (mean velocity change, 0.252 cm.sec(-1)) or flow (mean flow change, 0.018 mL.sec(-1)) was noted after placebo injection. The surface area of the varices did not change significantly after octreotide (mean change, -0.771 mm2) or placebo (mean change, -0.015 mm2) injection. CONCLUSION: Transesophageal MR imaging is a feasible method to assess the morphologic and hemodynamic characteristics of esophageal varices before and after pharmacologic treatment.

Analysis of Variance↗
PubMed2005

Preoperative assessment of pancreatic tumors using magnetic resonance imaging, endoscopic ultrasonography, positron emission tomography and laparoscopy.

BACKGROUND: The appropriate preoperative evaluation of a pancreatic tumor remains a matter of debate. METHODS: We retrospectively evaluated an institutional strategy including magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS), positron emission tomography (PET) and laparoscopy (LAP) for detection and staging of pancreatic tumors suspected to be malignant. RESULTS: In a consecutive series of 59 patients screened by MRI, PET, EUS and LAP between July 1998 and November 2002, 48 patients were found to bear pancreatic adenocarcinoma and surgery was performed in 27 of them. For tumor detection, the sensitivity of EUS was superior to MRI and PET (98 vs. 87.5 and 87.5%, respectively, p = 0.13). MRI best assessed loco-regional staging, i.e. arterial involvement. For the detection of distant metastases, the sensitivity of all preoperative examinations taken separately was low. When laparotomy was performed with a curative intent according to all four examinations, occult metastasis or carcinomatosis was discovered in 7/27 patients and the overall predictive value of resectability was thus 74%. Five-year and median survival were significantly better in resected vs. non-resected patients (39% and 26 months vs. 0% and 8 months, p = 0.0006). CONCLUSIONS: MRI can be recommended has the first examination in patients bearing pancreatic tumors, complemented by EUS if the findings of MRI are non-conclusive. For detection of distant metastasis, only the combination of all preoperative examination was proved to be more accurate than a single technique.

Adenocarcinoma↗
PubMed2005

Head-to-head comparison of three-dimensional navigator-gated magnetic resonance imaging and 16-slice computed tomography to detect coronary artery stenosis in patients.

OBJECTIVES: The purpose of this research was to compare the diagnostic accuracy of three-dimensional navigator-gated magnetic resonance (MR) imaging and 16-slice multidetector row computed tomography (MDCT) versus quantitative coronary angiography (QCA) for the detection of coronary artery stenosis in patients. BACKGROUND: Both MR and MDCT are novel non-invasive tests, which have been proposed for noninvasive detection of coronary artery disease. Yet their diagnostic accuracy has not been directly compared in the same population. METHODS: Fifty-two patients underwent coronary MR and 16-slice MDCT before invasive coronary angiography. Diameter stenosis (DS) severity in vessels >1.5-mm reference diameter were graded visually and measured quantitatively on both MR and MDCT images. Diagnostic accuracy of both methods was compared using QCA as the reference test. RESULTS: According to QCA, 81 of 452 (18%) coronary segments with >1.5 mm diameter had >50% DS. By visual analysis, MR and MDCT had similar sensitivity (75% vs. 82%, p = NS), specificity (77% vs. 79%, p = NS), and diagnostic accuracy (77%, vs. 80%, p = NS) for detection of >50 % DS. Quantitative measures of DS by MR (r = 0.60, p < 0.001) and MDCT (r = 0.75, both p < 0.001) correlated well with QCA. Receiver-operating characteristic analysis demonstrated that quantification of DS severity improved the diagnostic accuracy of MDCT (area under curve [AUC] 0.81 vs. 0.92, p < 0.001) but not that of MR (AUC 0.78 vs. 0.83, p = NS). CONCLUSIONS: Visual assessment of coronary diameter stenosis severity by MR or MDCT allows identification of significant coronary artery disease with a similar high diagnostic accuracy. Quantitative analysis significantly further improves the diagnostic accuracy of MDCT but not that of MR.

Aged↗
PubMed2005

Urinary calculi: improved detection and characterization with thin-slice multidetector CT.

The aim of this study was to assess the effect of reconstructed slice thickness on the detection and characterization of human urinary calculi on a multidetector helical CT scanner. Nineteen human urinary calculi of various chemical composition measuring 1.0-3.7 mm were embedded into agar in a chamber of a nylon body phantom. The phantom was imaged with a four detector-row CT scanner. The number of detected calculi increased as the reconstructed slice thickness decreased. Measured diameters and density of the visible calculi decreased as the slice thickness increased. The results of the present study support the use of thin reconstructed slices to detect and characterize urinary calculi.

Humans↗
PubMed2005

131I-Labelled-iodized oil for palliative treatment of hepatocellular carcinoma.

BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is growing in western countries. Poor liver status and tumour size make curative options scarce. Palliative treatments such as chemo-embolization are improving survival in selected patients, but side-effects are frequent. There is a need for the validation of alternative treatments. Metabolic radiotherapy using lipiodol labelled with 131I-iodine (I-131-lipiodol) is one of these treatments. OBJECTIVES: To analyse the effect of I-131-lipiodol in a population of advanced HCC patients and to define the potential prognostic factors in this setting. METHODS: A retrospective analysis of the effect of I-131-lipiodol on 29 patients bearing multifocal tumours was performed. An analysis of two subgroups, defined by a Cancer of the Liver Italian Program (CLIP) score of 2 or less (n=20) or greater than 2 (n=9) was performed to assess the prognostic significance of the score in this setting. RESULTS: Overall median survival in the entire study population was 203 days (95% confidence interval 83-322 days). Median survival was significantly better in the group with CLIP scores of 2 or less than in the group with CLIP scores greater than 2 (453 versus 60 days, P< or =0.001). Treatment-related mortality was 6.9% (one interstitial pneumonia and one acute liver failure). CONCLUSION: The survival of patients treated with I-131-lipiodol in this series compared favourably with published data. Stratification according to the CLIP score was useful to predict survival. In particular, patients with portal vein thrombosis should only be considered for I-131-lipiodol if the CLIP score is lower than 2.

Adult↗
PubMed2004

Liver segmentation in living liver transplant donors: comparison of semiautomatic and manual methods.

PURPOSE: To compare the accuracy and repeatability of a semiautomatic segmentation algorithm with those of manual segmentation for determining liver volume in living liver transplant donors at magnetic resonance (MR) imaging. MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived the requirement for informed consent. The semiautomatic segmentation algorithm is based on geometric deformable models and the level-set technique. It entails (a) placing initialization circle(s) on each image section, (b) running the algorithm, (c) inspecting and possibly manually modifying the contours obtained with the segmentation algorithm, and (d) placing lines to separate the liver segments. For 18 living donors (eight men and 10 women; mean age, 34 years; age range, 25-46 years), two observers each performed two semiautomatic and two manual segmentations on contrast material-enhanced T1-weighted MR images. Each measurement was timed. Actual graft weight was measured during surgery. The time needed for manual and that needed for semiautomatic segmentation were compared. Accuracy and repeatability were evaluated with the Bland-Altman method. RESULTS: Mean interaction time was reduced from 25 minutes with manual segmentation to 5 minutes with semiautomatic segmentation. The mean total time for the semiautomatic process was 7 minutes 20 seconds. Differences between the actual volume and the estimated volume ranged from -223 to +123 mL for manual segmentation and from -214 to +86 mL for semiautomatic segmentation. The 95% limits of agreement for the ratio of actual graft volume to estimated graft volume were 0.686 and 1.601 for semiautomatic segmentation and 0.651 and 1.957 for manual segmentation. Semiautomatic segmentation improved estimation in 15 of 18 cases. Inter- and intraobserver repeatability was higher with semiautomatic segmentation. CONCLUSION: Use of the semiautomatic segmentation algorithm substantially reduces the time needed for volumetric measurement of liver segments while improving both accuracy and repeatability.

Adult↗
PubMed2004

Coronary artery stenosis: direct comparison of four-section multi-detector row CT and 3D navigator MR imaging for detection--initial results.

PURPOSE: To prospectively compare the diagnostic accuracy of multi-detector row computed tomography (CT) and of three-dimensional (3D) navigator magnetic resonance (MR) imaging in patients referred for conventional coronary angiography for detection of coronary artery stenosis. MATERIALS AND METHODS: All patients gave written informed consent for the study, which was approved by the local ethics committee. Twenty-seven patients underwent multi-detector row CT and 3D navigator free-breathing MR imaging a mean of 5 days before undergoing invasive coronary angiography. The acquired multi-detector row CT and MR images were graded for the presence of greater than 50% stenosis in vessels larger than 1.5 mm in diameter. The diagnostic accuracies of the two examinations were compared with that of quantitative coronary angiography (QCA) by using the McNemar test. RESULTS: Owing to claustrophobia, MR images were not acquired in one patient; thus, 26 patients were included for analysis. According to QCA findings, 21 of the 26 patients had significant coronary artery disease and 58 (20%) of a total of 294 coronary artery segments larger than 1.5 mm in diameter had significant (>50%) stenosis. Multi-detector row CT had significantly higher sensitivity (46 [79%] of 58 segments) than MR imaging (36 [62%] segments, P < .05) for detection of segments with significant stenosis. Conversely, MR imaging had significantly higher specificity (198 [84%] of 236 segments) than did CT (168 [71%] segments, P < .001) for exclusion of segmental coronary artery stenosis. Both examinations had high negative predictive value for exclusion of segmental stenosis: 93% (168 of 180 segments) for CT and 90% (198 of 220 segments) for MR imaging. The overall diagnostic accuracy of MR imaging (80% [234 of 294 segments]) was significantly higher than that of CT (73% [214 segments], P < .05). CONCLUSION: MR imaging had significantly higher diagnostic accuracy than multi-detector row CT in the evaluation of coronary artery stenosis. Both techniques have high negative predictive value, making them particularly useful for ruling out coronary artery disease in symptomatic patients.

Adult↗
PubMed2004

Hepatic haemangioendothelioma in adults: excellent outcome following liver transplantation.

Hepatic epithelioid haemangioendotheliomas (HEHEs) are rare, low-grade vascular tumours. Five adults with HEHEs and one adult with a vascular tumour showing combined features of haemangioma and haemangioendothelioma underwent liver transplantation. Two HEHE patients had extrahepatic metastases at the time of transplantation. Median survival time following diagnosis was 10.7 years (range 40 months to 195 months). One patient needed resection of a HEHE in the breast 13 years post-transplantation. All six patients are surviving free from disease 22 to 166 months after transplantation (median 77 months). One HEHE-patient who had been treated for 8 years for vertebral and cerebral localisations is free of disease without immunosuppression 56 months after transplantation. We can conclude that liver transplantation is a valuable treatment for hepatic haemangioendothelioma, even in cases of extrahepatic localisation of the disease.

Adult↗
PubMed2004

Glomerular filtration rate: assessment with dynamic contrast-enhanced MRI and a cortical-compartment model in the rabbit kidney.

PURPOSE: To describe the use of MRI and a cortical-compartment model to measure the glomerular filtration rate (GFR), and compare the results with those obtained with the Patlak-Rutland model. MATERIALS AND METHODS: Dynamic MRI of rabbit kidneys was performed during and after injection of gadoterate dimeglumine. The enhancement curves in the aorta and the kidney were analyzed with the cortical-compartment and Patlak-Rutland models to assess the GFR. RESULTS: A substantial correlation was observed between the GFR measured with MRI using the cortical-compartment model and the plasma clearance of 51Cr-EDTA (r=0.821, P=0.004). No significant correlation was observed between the 51Cr-EDTA clearance (r=0.628, P=0.052) and the GFR obtained with the Patlak-Rutland model in regions of interest (ROIs) encompassing the renal cortex and medulla. A Bland and Altman analysis showed that GFR(cortical) (compartment) agreed better with the 51Cr-EDTA clearance compared to GFR(Patlak) when ROIs were limited to the cortex. However, the GFR values obtained by MRI were lower than the plasma clearance of 51Cr-EDTA. CONCLUSION: MRI with a cortical-compartment model provides more accurate assessments of glomerular filtration than the Patlak-Rutland model.

Animals↗
PubMed2004

Inflow correction of hepatic perfusion measurements using T1-weighted, fast gradient-echo, contrast-enhanced MRI.

Inflow effects were studied for T(1)-weighted, fast gradient-echo, contrast-enhanced MRI. This was done on the basis of realistic simulations (e.g., taking slice profiles into account) for unsteady flow. The area under the point spread function (PSF) was used to estimate the flow-related enhancement. A simple analytical model that accurately describes the inflow effects was derived and validated. This model was used to correct the experimental perfusion calibration curves (signal intensity vs. relaxation rate) for inflow effects. Hepatic perfusion measurements, performed on patients, were analyzed in terms of a dual-input, first-order linear model. It was shown that inflow causes incorrect perfusion input functions. The resulting estimated perfusion parameters displayed a systematic error of typically 30-40%. By performing two extra time-resolved flow measurements during the examination, one can correct the input functions.

Adult↗
PubMed2003

Hepatic flow parameters measured with MR imaging and Doppler US: correlations with degree of cirrhosis and portal hypertension.

PURPOSE: To determine the correlations between hemodynamic parameters of hepatic flow measured with magnetic resonance (MR) imaging and Doppler ultrasonography (US) and the severity of cirrhosis and portal hypertension. MATERIALS AND METHODS: Forty-six patients referred for measurements of portal venous pressure (three with normal liver, 12 with chronic hepatitis, and 31 with cirrhosis [10 with Child-Pugh class A cirrhosis; 13 with class B cirrhosis; and eight with class C cirrhosis]) were included in the study. Apparent liver perfusion, apparent arterial and portal perfusion, portal fraction, distribution volume, and mean transit time were measured with dynamic contrast material-enhanced MR imaging. Portal velocity, portal flow, congestion index, right hepatic artery resistance index, and modified hepatic index were measured with Doppler US. Results in patients with cirrhosis and those without cirrhosis were compared with the Wilcoxon rank sum test. Correlations were assessed with Spearman rank correlation coefficients. RESULTS: With MR imaging, all flow parameters except distribution volume were significantly different between patients with and those without cirrhosis (P <.05). There was a significant correlation between all flow parameters measured with MR imaging and portal pressure (P <.02). Apparent arterial (P =.024) and portal (P <.001) perfusion, portal fraction (P <.001), and mean transit time (P =.004) were correlated with Child-Pugh class. Flow parameters measured with Doppler US did not differ significantly between patients with and those without cirrhosis. Only right hepatic arterial resistance (P <.007) and portal flow (P <.043) were weakly (r < 0.7) correlated with portal pressure. No Doppler US parameter was correlated with Child-Pugh class. CONCLUSION: Hepatic flow parameters measured with MR imaging correlate with the severity of cirrhosis and portal hypertension. Doppler US parameters are only weakly correlated with portal pressure.

Adolescent↗
PubMed2003

Capillarization of the sinusoids in liver fibrosis: noninvasive assessment with contrast-enhanced MRI in the rabbit.

Sinusoidal capillarization induces microcirculatory changes in liver cirrhosis and fibrosis. The purpose of this study was to assess whether contrast-enhanced MRI can be used to demonstrate the effects of sinusoidal capillarization in liver fibrosis. Dynamic MRI after injection of a low-molecular-weight contrast agent of 0.56 kDa (Gd-DOTA), and two high-molecular-weight contrast agents of 6.47 kDa and 52 kDa (P792 and P717) was performed in rabbits with liver fibrosis induced by cholesterol and diethylstilbestrol. The hepatic distribution volume accessible to the high-molecular-weight agents decreased in the rabbits with liver fibrosis (P792: 7.8% +/- 1.7% vs. 10.1% +/- 1.8% in normal rabbits, P =.038; P717: 6.2% +/- 2.1% vs. 9.7% +/- 1.6% in normal rabbits, P =.007), whereas the hepatic mean transit time (MTT) of the low-molecular-weight agent was increased (15.9 +/- 8.0 s vs. 8.8 +/- 2.6 s in normal rabbits, P =.015). In rabbits with liver fibrosis, the clearance of indocyanine green (ICG) was correlated with the volume accessible to the high-molecular-weight agents (P792: r = 0.810, P =.015; P717: r = 0.857, P =.007). The collagen content of the liver was inversely correlated with the distribution volume of P717 (r = -.833, P =.010) and with the ICG clearance (r = -.810, P =.015). It was concluded that the microcirculatory changes induced by sinusoidal capillarization in liver fibrosis can be demonstrated noninvasively with MRI.

Animals↗
PubMed2002

Persistent decreased plasma cholecystokinin levels in celiac patients under gluten-free diet: respective roles of histological changes and nutrient hydrolysis.

Celiac disease is associated with impaired cholecystokinin (CCK) release. The mechanism by which CCK release is impaired is poorly understood and seems to be related to the mucosal atrophy or to decreased stimulation due to reduced intraduodenal nutrient hydrolysis. The aims of our study were to evaluate basal and postprandial CCK in celiac patients presenting with distinctive types of mucosal lesions (normal, infiltrative and atrophic), and to study the role of protein hydrolysis on CCK release. Plasma CCK was measured in 20 celiac patients (normal mucosa: n=6; infiltrative type: n=6; atrophic type=8) and 9 controls, before and after ingestion of a polymeric or a semi-elemental meal. Significant decreases in basal CCK plasma (B 0.6 [95% CI, 0.3-1.3] pmol/l; p<0.003) and postprandial CCK area under curve (AUC 34 [19-61] pmol/l x 120 min, p<0.0001) were observed in patients with an atrophic mucosa compared with treated patients (B 1.6 [1.0-2.4] pmol/l, AUC 267 [172-414] pmol/l x 120 min) or healthy volunteers (B 1.0 [0.7-1.4] pmol/l, AUC 186 [131-264] pmol/l x 120 min). A significant defective CCK release was also observed in patients with an infiltrative type: B 0.4 [0.2-0.7] pmol/l and AUC 56 [31-101] pmol/l x 120 min; p<0.0001. Administration of a semi-elemental diet did not correct the defective CCK release. In conclusion, the decreased CCK levels observed in celiac patients are not strictly related to the mucosal atrophy but rather to the lymphocytic infiltrate. Administration of a predigested meal did not correct the impaired CCK release. Some inhibitory mechanism could be involved in the CCK cell dysfunction observed in celiac patients presenting with lesser degrees of disease activity.

Adult↗
PubMed2002

Dynamic computed tomography with low- and high-molecular-mass contrast agents to assess microvascular permeability modifications in a model of liver fibrosis.

Interstitial collagen formation and transformation of the fenestrated hepatic sinusoids into continuous capillaries are major ultrastructural changes that occur in liver cirrhosis and fibrosis. These modifications lead to progressive restriction of blood-liver exchanges. The purpose of our study was to evaluate the permeability changes in a model of hepatic fibrosis by using dynamic computed tomography (CT) enhanced with contrast agents of different molecular masses. Dynamic single-section CT of the liver was performed after intravenous bolus administration of a low-molecular-mass contrast agent (iobitridol) and an experimental high-molecular-mass agent (P840) in normal control rabbits and in rabbits with hepatic fibrosis. Hepatic, aortic and portal venous time-density curves were fitted with a dual-input one-compartmental model to calculate the hepatic mean transit time and distribution volume of the contrast agents. In the rabbits with liver fibrosis, the mean transit time of the high-molecular-mass agent was shorter than that of the low-molecular-mass agent (10.0+/-1.8 s and 12.0+/-1.2 s respectively; P<0.05). The distribution volume accessible to the high-molecular-mass agent was also smaller (22.2+/-4.8% compared with 32.0+/-6.7%; P<0.01). In the normal rabbits, the mean transit times of the high- and low-molecular-mass agents did not differ significantly, and nor did their distribution volumes. Our results demonstrate decreased sinusoidal permeability for the high-molecular-mass agent P840 in a model of hepatic fibrosis. Non-invasive assessment of permeability changes in liver fibrosis can be performed with dynamic CT and contrast agents of different molecular masses.

Animals↗
PubMed2002

Long-term asymptomatic biochemical cholestasis after fulminant or subfulminant liver failure is associated with extensive postnecrotic collapse with regeneration of the liver.

Fulminant or subfulminant liver failure usually leads to liver failure or to recovery. In rare instances, patients who recover exhibit prolonged asymptomatic biochemical cholestasis which coincides with the development into the parenchyma of large postnecrotic collapse with regeneration. This hitherto poorly recognized form of recovery may now be assessed by noninvasive techniques such as magnetic resonance imaging. We report the case of three patients who recovered from fulminant or subfulminant liver failure and in whom investigation of long-term biochemical cholestasis led to that unusual diagnosis.

Adult↗