Original Research

Overlap syndrome of autoimmune chronic liver diseases: MRI findings

  1. W. Brian Hyslop MD, PhD*,
  2. Andrea S. Kierans BSc,
  3. Polytimi Leonardou MD, PhD,
  4. Karen Fritchie MD,
  5. Jama Darling MD,
  6. Mohamed Elazazzi MD,
  7. Richard C. Semelka MD

Article first published online: 23 JAN 2010

DOI: 10.1002/jmri.22048

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 31, Issue 2, pages 383–389, February 2010

Additional Information

How to Cite

Hyslop, W. B., Kierans, A. S., Leonardou, P., Fritchie, K., Darling, J., Elazazzi, M. and Semelka, R. C. (2010), Overlap syndrome of autoimmune chronic liver diseases: MRI findings. J. Magn. Reson. Imaging, 31: 383–389. doi: 10.1002/jmri.22048

Author Information

  1. Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

*UNC at Chapel Hill, Department of Radiology, CB#7510 – 2016 Old Clinic Bldg, Chapel Hill, NC 27599-7510

Publication History

  1. Issue published online: 23 JAN 2010
  2. Article first published online: 23 JAN 2010
  3. Manuscript Accepted: 2 NOV 2009
  4. Manuscript Received: 26 MAR 2009

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Keywords:

  • autoimmune;
  • MRI;
  • liver disease;
  • overlap syndrome

Abstract

Purpose:

To describe the MR findings of overlap syndromes of autoimmune chronic liver diseases.

Methods:

Review of clinical and radiological databases between March 2001 and July 2008 for patients with a clinical diagnosis and liver biopsy features compatible with overlap syndrome who had also undergone an abdominal MRI yielded 15 adult patients. MR features of overlap syndrome were reviewed by two radiologists by consensus. Two radiologists independently reviewed the studies in a blinded fashion for primary sclerosing cholangitis (PSC)-type or non-PSC-type features to assess interobserver agreement.

Results:

PSC-type and non-PSC-type overlap syndrome had distinctive MR features. In the consensus review, all 12 patients with PSC-type overlap syndrome were correctly identified. Imaging findings included central macroregeneration (N = 9), peripheral atrophy (N = 7), biliary duct beading (N = 12), biliary dilation (N = 10), or a combination of all four findings (N = 7). The presence of any of the first three features had 100% specificity for a PSC-type overlap syndrome. Patients with non-PSC-type overlap (N = 3) showed relatively normal liver morphology (N = 3) and minimal biliary ductal dilatation in one patient. There was good interobserver agreement (kappa = 0.76).

Conclusion:

Patients with serologic or pathologic evidence of AIH or PBC with imaging features of PSC may have PSC-type overlap syndrome. J. Magn. Reson. Imaging 2010; 31: 383–389. © 2010 Wiley-Liss, Inc.

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