Fleury Group, São Paulo, Brazil; Department of Diagnostic Imaging, Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Fleury Group, São Paulo, Brazil; Department of Diagnostic Imaging, Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Clin Imaging. 2021 Jun;74:31-40. doi: 10.1016/j.clinimag.2020.12.032. Epub 2021 Jan 5.
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown origin that can lead to liver cirrhosis, hepatocellular carcinoma (HCC), liver transplantation or death. The diagnosis is performed upon a multifactorial score. Treatment is based on the combination of immunosuppressants and aims at clinical, laboratory and histological remission, the latter being the most difficult to be achieved and proven. The absence of liver inflammation, defined by biopsy, is the main determinant in remission or therapeutic modification. Imaging exams have a limited role in this clinical management and the main findings are those related to chronic liver disease. Imaging's relevance, therefore, lies mainly in helping to exclude overlapping syndromes and in assessing complications related to cirrhosis, such as in screening for HCC. In recent years, however, the radiological literature has been witnessing increasing advances with regard to imaging biomarkers in liver disease, leading some authors to consider a future of virtual liver biopsy performed by magnetic resonance imaging. The present study aims to review the role of imaging in the management of AIH in the light of recent advances in the current literature and to provide an illustrated guide with the main findings described in the disease.
自身免疫性肝炎（AIH）是一种病因不明的慢性炎症性肝病，可导致肝硬化、肝细胞癌（HCC）、肝移植或死亡。该诊断是基于多因素评分进行的。治疗基于免疫抑制剂的联合应用，旨在实现临床、实验室和组织学缓解，后者是最难实现和证实的。肝活检定义的无炎症是缓解或治疗改变的主要决定因素。影像学检查在这种临床管理中的作用有限，主要发现与慢性肝病有关。因此，影像学的相关性主要在于帮助排除重叠综合征，并评估与肝硬化相关的并发症，如 HCC 的筛查。然而，近年来，影像学文献在肝病的影像学生物标志物方面取得了越来越多的进展，一些作者认为未来可以通过磁共振成像进行虚拟肝活检。本研究旨在根据当前文献中的最新进展，回顾影像学在 AIH 管理中的作用，并提供一个带有疾病主要发现的说明性指南。
