Abstract: Objective The aim of this study was to investigate the clinical value of quantitative MRI and serological indexes in the diagnosis of portal hypertension (PH) in patients with primary biliary cirrhosis (PBC). Methods Forty-five patients with PBC were admitted to our hospital from January 2010 through December 2018. The aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) were obtained. All patients with PBC underwent MRI examination. The receiver-operating characteristic curve (ROC curve) was drawn to analyze the diagnostic value of quantitative MRI index, APRI and FIB-4 for portal hypertension diagnosis. Results 14 (31.1%) patients with PBC in our series had PH; in the 14 patients with PH, the APRI score was 2.21(1.82,2.74), FIB-4 score was 1.65(1.02,1.94), liver stiffness was 4.87(4.15, 5.46)kPa, spleen stiffness was 9.75(7.54, 11.77)kPa, T1 of liver was 1024.8(975.4, 1078.5)ms, T2 of liver was 62.7(57.4, 68.4)ms, and ADC was 1.29(1.11, 1.62)×10^-3mm²/s, significantly higher than 0.68(0.21, 0.94), 0.24(0.18, 0.42), 2.51(2.11, 2.98)kPa, 5.23(4.62, 6.08)kPa, 930.8(870.9, 980.4)ms, 56.8(55.3, 58.7)ms and 1.08(1.02, 1.25)×10^-3mm²/s in 31 patients without PH (P<0.05); the sensitivity by APRI, FIB-4, liver and spleen stiffness by MR determination in diagnosing PH were 90.4%, 82.3%, 92.4% and 90.3%, and the specificity were 79.6%, 91.2%, 92.0% and 93.2%, respectively. Conclusion The serological indexes and liver and spleen stiffness determined by MRI might help judge the existence of portal hypertension in patients with PBC, which needs further investigation.

Key words: Primary biliary cirrhosis, Portal hypertension, Quantitative magnetic resonance imaging, Liver stiffness, Aspartate aminotransferase-to-platelet ratio index, Diagnosis