DOI: 10.1148/radiol.2301021176
Macrovesicular Hepatic Steatosis in Living Related Liver Donors: Correlation between CT and Histologic Findings1
Piyaporn Limanond, MD,
Steven S. Raman, MD,
Charles Lassman, MD,
James Sayre, MD,
R. Mark Ghobrial, MD, PhD,
Ronald W. Busuttil, MD, PhD,
Sammy Saab, MD and
David S. K. Lu, MD
1 From the Departments of Radiology (P.L., S.S.R., J.S., D.S.K.L.), Pathology (C.L.), Surgery (R.M.G., R.W.B.), and Digestive Diseases (S.S.), David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1721. Received September 13, 2002; revision requested November 22; final revision received April 30, 2003; accepted May 20. Address correspondence to S.S.R. (e-mail: SRaman@mednet.ucla.edu).
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Figure 1. Graph demonstrates high degree of correlation between LAI on y axis as a function of percentage of histologically confirmed macrovesicular steatosis on x axis across a range of values.
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Figure 2a. (a) Unenhanced transverse CT image obtained through the liver in a 30-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 9.3 HU, which represents a normal liver without substantial macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture without detectable macrovesicular steatosis. (Hematoxylin-eosin stain; original magnificiation, x100.)
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Figure 2b. (a) Unenhanced transverse CT image obtained through the liver in a 30-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 9.3 HU, which represents a normal liver without substantial macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture without detectable macrovesicular steatosis. (Hematoxylin-eosin stain; original magnificiation, x100.)
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Figure 3a. (a) Unenhanced transverse CT image obtained through the liver in a 46-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 7.4 HU, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture with 10% macrovesicular steatosis (arrows). (Hematoxylin-eosin stain; original magnification, x100.) (c) Specimen shows moderate degree of hemosiderin deposition (arrows), which masks the degree of histologically confirmed steatosis. (Reticulin stain; original magnification, x200.)
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Figure 3b. (a) Unenhanced transverse CT image obtained through the liver in a 46-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 7.4 HU, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture with 10% macrovesicular steatosis (arrows). (Hematoxylin-eosin stain; original magnification, x100.) (c) Specimen shows moderate degree of hemosiderin deposition (arrows), which masks the degree of histologically confirmed steatosis. (Reticulin stain; original magnification, x200.)
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Figure 3c. (a) Unenhanced transverse CT image obtained through the liver in a 46-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 7.4 HU, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture with 10% macrovesicular steatosis (arrows). (Hematoxylin-eosin stain; original magnification, x100.) (c) Specimen shows moderate degree of hemosiderin deposition (arrows), which masks the degree of histologically confirmed steatosis. (Reticulin stain; original magnification, x200.)
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Figure 4a. (a) Unenhanced transverse CT image obtained through the liver in a 33-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 9.1 HU, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows widened portal triads at left (arrows), compatible with abnormal zones of hepatocyte regeneration as a subsequent result of hepatic necrosis. Normal portal triads are at right (arrowheads). (Reticulin stain; original magnification, x100.)
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Figure 4b. (a) Unenhanced transverse CT image obtained through the liver in a 33-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 9.1 HU, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows widened portal triads at left (arrows), compatible with abnormal zones of hepatocyte regeneration as a subsequent result of hepatic necrosis. Normal portal triads are at right (arrowheads). (Reticulin stain; original magnification, x100.)
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Figure 5a. (a) Unenhanced transverse CT image obtained through the liver in a 51-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 8.4, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows inflammatory cells (arrows) infiltrating the portal triads, compatible with mild hepatitis. (Hematoxylin-eosin stain; original magnification, x200.)
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Figure 5b. (a) Unenhanced transverse CT image obtained through the liver in a 51-year-old male potential liver donor demonstrates a liver with normal attenuation. LAI is 8.4, which represents a normal liver without marked macrovesicular steatosis. (b) Corresponding histologic specimen shows inflammatory cells (arrows) infiltrating the portal triads, compatible with mild hepatitis. (Hematoxylin-eosin stain; original magnification, x200.)
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Figure 6a. (a) Unenhanced transverse CT image obtained through the liver in a 44-year-old male potential liver donor demonstrates a liver with diffuse decreased hepatic attenuation, which suggests steatosis. Central hepatic vessels cannot be appreciated. LAI is 3.8 HU, which represents 6%-30% macrovesicular steatosis. (b) Histologic specimen shows normal architecture with moderate steatosis of 30%. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 6b. (a) Unenhanced transverse CT image obtained through the liver in a 44-year-old male potential liver donor demonstrates a liver with diffuse decreased hepatic attenuation, which suggests steatosis. Central hepatic vessels cannot be appreciated. LAI is 3.8 HU, which represents 6%-30% macrovesicular steatosis. (b) Histologic specimen shows normal architecture with moderate steatosis of 30%. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 7a. (a) Unenhanced transverse CT image obtained through the liver in a 43-year-old female potential liver donor demonstrates a liver with markedly decreased attenuation, even lower than the attenuation of the central hepatic vessels. LAI is -47.4 HU, which represents greater than 30% macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture with severe steatosis (80%). (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 7b. (a) Unenhanced transverse CT image obtained through the liver in a 43-year-old female potential liver donor demonstrates a liver with markedly decreased attenuation, even lower than the attenuation of the central hepatic vessels. LAI is -47.4 HU, which represents greater than 30% macrovesicular steatosis. (b) Corresponding histologic specimen shows normal architecture with severe steatosis (80%). (Hematoxylin-eosin stain; original magnification, x100.)
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Copyright © 2004 by the Radiological Society of North America.
