Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging.
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.
Verma
Sachit K
SK
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. medskv@yahoo.com
Mitchell
Donald G
DG
Bergin
Diane
D
Lakhman
Yulia
Y
Austin
Amy
A
Verma
Manisha
M
Assis
David
D
Herrine
Stevene K
SK
Parker
Laurence
L
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