Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging.

Overview

BACKGROUND: In order to retrospectively determine the frequency of dilated cisterna chyli (CC) on MR images in patients with cirrhosis, and to assess its value as a simple diagnostic imaging sign of uncompensated cirrhosis. METHODS: Study population included 257 patients (149 with pathologically proved cirrhosis and 108 control subjects without the history of chronic liver diseases) who had 1.5 T MR imaging. Cirrhosis patients were divided into compensated and uncompensated groups. Three independent observers qualitatively evaluated the visibility of CC 2 mm or greater in transverse diameter, identified as a tubular structure with fluid signal intensity. CC diameters greater than 6 mm were defined as dilated. Statistical analysis was performed by Student t-test and interobserver agreement via intraclass correlation coefficient. RESULTS: CCs with diameter 2 mm or more were recorded in 113 of 149 (76%) cirrhotic patients and 15 of 108 (14%) control subjects (P < 0.001). Dilated CCs were significantly more frequent in uncompensated than compensated cirrhotic patients (54% vs 5%, P < 0.001). The sensitivity, specificity, accuracy, and positive predictive value of dilated CC for uncompensated cirrhosis were 54%, 98%, 80%, and 96%, respectively. CONCLUSIONS: Dilated CC can be used as a simple and specific sign complimentary to other findings of uncompensated cirrhosis.