Reversible heterogeneous arterial phase liver perfusion associated with transient acute hepatitis: findings on gadolinium-enhanced MRI

PURPOSE: To assess a possible correlation between active acute hepatitis and the development of abnormal liver perfusion demonstrated as heterogeneous enhancement on arterial phase gadolinium-enhanced MRI. Dynamically-enhanced MRI of the liver can detect reversible perfusion abnormalities that correlate with acute hepatitis. MATERIALS AND METHODS: Six patients presenting with symptoms and clinical findings in keeping with transient acute hepatitis underwent serial MRI of the liver throughout the course of the disease. Serial liver enzyme analysis was performed for all six patients, and histopathology was assessed for three patients. Imaging included gadolinium-enhanced arterial and venous-phase gradient-echo sequences. RESULTS: Arterial phase gadolinium-enhanced MRI showed abnormal irregular liver perfusion in the setting of acute hepatitis, and the degree of irregularity, as well as the persistence of irregular enhancement into the venous phase, correlated with the clinical severity of the disease. CONCLUSION: Acute hepatitis can cause irregular enhancement of the liver on arterial-phase, gadolinium-enhanced, gradient-echo MRI, a reversible finding that improves with clinical improvement of the disease.