Usefulness of noninvasive tests in nodular regenerative hyperplasia of the liver.
BACKGROUND
The only way to diagnose nodular regenerative hyperplasia (NRH) is liver biopsy.


OBJECTIVE
To evaluate in a prospective study the performance of noninvasive liver investigations in patients with NRH.


METHODS
All consecutive patients with NRH who were being followed up in our unit from 2004 to 2007 were included. All biopsy specimens were reanalysed independently to confirm the diagnosis of NRH (classified as certain or probable) and to assess portal or sinusoidal associated fibrosis. All patients had liver stiffness (using FibroScan) and FibroTest measurements. Magnetic resonance imaging (MRI) was performed using two contrast agents (gadolinium-chelate and ferucarbotran).


RESULTS
Thirty patients were included (mean age: 53 years). Median liver stiffness value was 7.9 kPa (range: 3.5-16.8), with 63% of the patients having more than 7.1 kPa. No relationship was found between NRH with or without portal hypertension and liver stiffness or Fibrotest. No correlation was found between liver stiffness and portal and/or sinusoidal fibrosis. In patients studied with MRI, 55% had portal hypertension and 9% a diffuse fine-nodular loss of iron uptake after ferucarbotran injection.


CONCLUSIONS
Liver stiffness and FibroTest values may be increased in NRH patients, with no correlation with portal hypertension or portal and sinusoidal fibrosis. Contrast-enhanced MRI is disappointing in NRH.
Laharie
David
D
Inserm U853, Université Victor Segalen Bordeaux 2, France. david.laharie@chu-bordeaux.fr
Vergniol
Julien
J
Bioulac-Sage
Paulette
P
Diris
Benoit
B
Poli
Julie
J
Foucher
Juliette
J
Couzigou
Patrice
P
Drouillard
Jacques
J
de Lédinghen
Victor
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001706:Biopsy; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications / Q000473:pathology; D006801:Humans; D006965:Hyperplasia / Q000150:complications / Q000473:pathology; D006975:Hypertension, Portal / Q000473:pathology*; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase