Abstract
BACKGROUND: To identify the magnetic resonance imaging (MRI) features of confluent hepatic fibrosis (CHF) caused by different etiologies. METHODS: The imaging features of 50 patients with CHF on liver MRI were retrospectively analyzed on conventional and contrast-enhanced sequences. RESULTS: Patients were subgrouped by different etiology (alcoholic liver disease, chronic hepatitis B, drug-induced liver injury, autoimmune hepatitis, primary sclerosing cholangitis, and others). The median age of the patients was 55 years, and 68% were female. On MRI, CHF lesions were predominantly radial and wedge-shaped patches, located in proximity to the second hepatic hilum, and exhibited delayed enhancement. On T1-weighted imaging (T1WI), 94% of CHF lesions presented hypointensity; on T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps, most CHF lesions demonstrated mild to moderate hyperintensity. Some lesions also demonstrated diffusely distribution around the vascular (16%) and subcapsular regions (18%), with mild to moderate enhancement on the late arterial phase. 76% of CHF lesions were accompanied by liver cirrhosis, and 62% cases were associated with capsular retraction. CONCLUSIONS: The clinical and MRI characteristics of CHF minimally vary across different etiology of liver disease. CHF lesions predominantly exhibit radial distribution from the second hepatic hilum, accompanied by consistent delayed enhancement and capsular retraction.