Abstract: Objective The aim of this study was to summarize the imaging and liver histopathological features in patients with idiopathic non-cirrhotic portal hypertension (INCPH) and to find the differential clue from patients with liver cirrhosis (LC). Methods Sixteen patients with INCPH and twenty-eight patients with hepatitis B-induced LC were encountered in our hospital between January 2016 and July 2021, and all underwent ultrasonography, CT, MR and liver biopsies. Results The imaging check-up showed that there were significant differences as respect to liver diffuse nodular changes (0.0% vs. 35.7%), portal vain diameters [9.7(7.2, 11.6)mm vs. 13.6(9.2, 15.7)mm], and portal vain wall thickness [2.6(1.4, 4.0)mm vs. 1.4(1.1, 1.6)mm] between the two groups(P<0.05); the liver histopathological examination demonstrated that there were significant differences respect to portal vein region fibrosis, hepatic diaphragm fibrosis, hepatic interlobular vein occlusion, hepatocyte necrosis or edema and hepatocyte steatosis [100.0% vs. 0.0%, 18.7% vs. 92.8%, 56.2% vs. 10.7%, 0.0% vs. 75.0% and 12.5% vs. 89.3%] between the two groups (P<0.05). Conclusion INCPH is still a disease of unknown etiology. The liver imaging and histopathological features might help differentiate it from liver cirrhosis.

Key words: Idiopathic noncirrhotic portal hypertension, Liver cirrhosis, Imaging feature, Portal vein region fibrosis