Periportal halo sign (MRI)

Last revised by Francis Deng on 28 Jan 2021

The periportal halo sign on liver MRI is a specific sign of primary biliary cholangitis (formerly primary biliary cirrhosis) that is characterized by rounded low signal intensity around portal venous branches, 5-10 mm in size, on T1- and T2-weighted images. These lesions are usually numerous, involve all hepatic segments, and do not exert mass effect 1. It should not be confused with the CT periportal halo indicating edema, which on MR is instead referred to as periportal hyperintensity or cuffing 2,3. The MR periportal halo sign reflects stellate areas of hepatocellular parenchymal extinction and fibrosis centered around the portal triads and a larger surrounding rosette of regenerating nodules 1,2. The quantity of halo signs on MRI may correlate with the histological stage of liver fibrosis 2.

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