title: Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging.
abstract: BACKGROUND
  In order to retrospectively determine the frequency of dilated cisterna chyli (CC) on MR images in patients with cirrhosis, and to assess its value as a simple diagnostic imaging sign of uncompensated cirrhosis.
  
  
  METHODS
  Study population included 257 patients (149 with pathologically proved cirrhosis and 108 control subjects without the history of chronic liver diseases) who had 1.5 T MR imaging. Cirrhosis patients were divided into compensated and uncompensated groups. Three independent observers qualitatively evaluated the visibility of CC 2 mm or greater in transverse diameter, identified as a tubular structure with fluid signal intensity. CC diameters greater than 6 mm were defined as dilated. Statistical analysis was performed by Student t-test and interobserver agreement via intraclass correlation coefficient.
  
  
  RESULTS
  CCs with diameter 2 mm or more were recorded in 113 of 149 (76%) cirrhotic patients and 15 of 108 (14%) control subjects (P < 0.001). Dilated CCs were significantly more frequent in uncompensated than compensated cirrhotic patients (54% vs 5%, P < 0.001). The sensitivity, specificity, accuracy, and positive predictive value of dilated CC for uncompensated cirrhosis were 54%, 98%, 80%, and 96%, respectively.
  
  
  CONCLUSIONS
  Dilated CC can be used as a simple and specific sign complimentary to other findings of uncompensated cirrhosis.
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. medskv@yahoo.com
authors.forename: Sachit K
authors.initials: SK
authors.lastname: Verma
authors.forename: Donald G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: Diane
authors.initials: D
authors.lastname: Bergin
authors.forename: Yulia
authors.initials: Y
authors.lastname: Lakhman
authors.forename: Amy
authors.initials: A
authors.lastname: Austin
authors.forename: Manisha
authors.initials: M
authors.lastname: Verma
authors.forename: David
authors.initials: D
authors.lastname: Assis
authors.forename: Stevene K
authors.initials: SK
authors.lastname: Herrine
authors.forename: Laurence
authors.initials: L
authors.lastname: Parker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013897:Thoracic Duct / Q000473:pathology*; D055815:Young Adult