Periportal hyperintensity sign on Gd-BOPTA-enhanced hepatobiliary phase MRI identifies patients less likely to achieve recompensation in decompensated cirrhosis.

Authors

Zhaojuan Wu, Yuchen Hao, Shize Xu, Yunfei Zang, Lianbang Wang, Ziding Tian, Yuemin Feng, Honggui Cao, Xinya Zhao, Qiang Zhu

Published in

Abdominal radiology (New York). Jul 15, 2026. Epub Jul 15, 2026.

Abstract

To determine the association between periportal hyperintensity sign from gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatobiliary phase magnetic resonance imaging (MRI) and the occurrence of recompensation in patients with decompensated cirrhosis.
This retrospective study included 252 patients with decompensated cirrhosis who underwent Gd-BOPTA-enhanced MRI at the time of decompensation. The periportal hyperintensity sign in the hepatobiliary phase was documented. Recompensation was defined using modified Baveno VII criteria. Cox proportional hazards regression was used to evaluate the association between the periportal hyperintensity sign and recompensation. Sensitivity analyses and bootstrap resampling were performed to test the robustness of the results. Survival outcomes were explored according to recompensation status.
Of the 252 patients, 37 (14.7%) exhibited the periportal hyperintensity sign. Linear regression revealed that the periportal hyperintensity sign was significantly associated with a higher model for end-stage liver disease (MELD)-Na score (coefficient, 2.90; 95% confidence interval [CI], 1.00-4.81; p = 0.003). Eighty patients (31.7%) achieved recompensation after a median follow-up of 44.7 months (interquartile range, 16.9-73.7 months). Among the 37 patients with the periportal hyperintensity sign, 3 patients (8.1%) achieved recompensation. Periportal hyperintensity was independently associated with a lower probability of recompensation (hazard ratio, 0.17; 95% CI, 0.05-0.49; p = 0.004), and the association was directionally consistent across sensitivity analyses. Patients without the periportal hyperintensity sign demonstrated a significantly higher cumulative incidence of recompensation than those exhibiting the sign (p = 0.0029). Survival curves indicated significant differences between the recompensated and non-recompensated groups (p < 0.0001).
Periportal hyperintensity sign from Gd-BOPTA-enhanced hepatobiliary phase MRI may help identify patients less likely to achieve recompensation in decompensated cirrhosis.

PMID:
42455326
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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