MR Images of Bowel Wall Thickening in Patients with Minimal to Moderate Cirrhosis : Comparison with Clinical Findings

Kim, Mi Young; Mitchell, Donald G; Hann, Hie Won L; Parker, Laurence

Abstract

PURPOSE
: To evaluate the MR imaging findings of bowel wall thickening in patients with minimal to moderate cirrhosis, and analyze their clinical significances comparing with laboratory findings.
MATERIALS AND METHODS
: We assessed retrospectively the MRI findings of 123 patients with minimal to moderate cirrhosis, and compared these with the clinical laboratory findings. We evaluated the involved sites and MR image findings of thickened bowel wall, as well as the presence of collateral vessels, ascites, and splenic size. These were compared with serum albumin and bilirubin levels, and prothrombin time.
RESULTS
: Gastrointestinal wall thickening was detected at 37 sites in 25 patients (20%), and more frequently detected in moderate cirrhosis (29%) than in minimal cirrhosis (17%). Jejunum and ascending colon were the most common sites of bowel wall thickening; each was involved at 22 and 9 sites, respectively. Ascending colonic wall thickening was more commonly detected in moderate cirrhosis than in minimal cirrhosis. The thickened bowel wall showed symmetric contour, high signal intensity on T2-weighted images, mixed iso- and low signal intensity on T1-weighted images, and homogeneous or target-like enhancement. Serum albumin level was significantly lower in patients with bowel wall thickening (3.3+/-0.9 g/dl vs. 3.9+/-0.7 g/dl;p=0.0024). Serum bilirubin level was significantly higher in patients with bowel wall thickening (1.7+/-1.0 mg/dl vs. 1.4+/-1.2 mg/dl; p=0.0160). Bowel wall thickening did not significantly correlate with the presence of collateral vessels, ascites, splenic size, and prolongation of prothrombin time.
CONCLUSION
: In minimal to moderate cirrhosis, the MR imaging evaluation of bowel wall thickening was useful for estimating the severity of cirrhosis and laboratory findings.