title: Cirrhosis-related intrathoracic disease. Imaging features in 1038 patients.
abstract: OBJECTIVE
  To describe imaging features of cirrhosis-related intrathoracic disease.
  
  
  METHODS
  Chest CTs of 1038 cirrhotic patients (mean age 53 yrs; range, 17-79) were evaluated for: bronchoarterial ratio (BAR), arteriovenous malformations, interstitial opacities, emphysema, and pleural effusions. Lymphangiography, pulmonary angiography, cardiac ultrasound and scintigraphy were selectively performed.
  
  
  RESULTS
  Mean BAR was 0.83+/-0.19. In two patients with hepatopulmonary syndrome (HPS), mean BAR was 0.55. HRCT detected interstitial lung opacities in 15 patients. Signs of fibrosis were seen in 7 (only two associated to biliary cirrhosis) and interstitial edema in 8. Accurate pattern recognition was achieved in 10/15 cases (66.6%). Of the 93 patients with emphysema only one had documented alpha1-AT deficiency (1.08%). Multiple type 1 vascular dilatations were visualized in two patients with HPS. Hepatic hydrothorax was present in 49 patients (4.72%); right-sided in 34 (69.4%), bilateral in 9 (18.4%) and left-sided in 6 (12.2%). Hepatic chylothorax was confirmed in 3 patients. Lymphangiography demonstrated the site of leakage and the engorged thoracic duct.
  
  
  CONCLUSIONS
  CT can identify intrathoracic pathology associated with liver disease. Decreased BAR is highly specific for HPS. However, a multimodality approach is necessary to depict cases of liver origin.
authors.affiliation: 2nd Department of Radiology, Medical School, University of Athens, Greece. kmalag@acn.gr
authors.forename: K
authors.initials: K
authors.lastname: Malagari
authors.forename: A
authors.initials: A
authors.lastname: Nikita
authors.forename: E
authors.initials: E
authors.lastname: Alexopoulou
authors.forename: E
authors.initials: E
authors.lastname: Brountzos
authors.forename: M
authors.initials: M
authors.lastname: Papathanasiou
authors.forename: J
authors.initials: J
authors.lastname: Mitromaras
authors.forename: E
authors.initials: E
authors.lastname: Zakynthinos
authors.forename: S
authors.initials: S
authors.lastname: Papiris
authors.forename: D A
authors.initials: DA
authors.lastname: Kelekis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001160:Arterioles / Q000000981:diagnostic imaging; D001980:Bronchi / Q000098:blood supply; D020065:Hepatopulmonary Syndrome / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008875:Middle Aged; D013902:Radiography, Thoracic; D011877:Radionuclide Imaging; D013896:Thoracic Diseases / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography