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By Aldous Huxley (ed.)

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Copyright 2002 John Wiley. This material is used by permission of John Wiley & Sons, Inc. suppressed Gd T1-W spin echo (b, c) images in a patient with ulcerative colitis complicated by toxic megacolon. Precontrast, there are low-signal-intensity strands in the pericolonic fat (arrows, a). After contrast, there is intense enhancement of the sigmoid colon (asterisks, b, c) and vasa rectae (long arrows, b, c). Though a feature of ulcerative colitis is submucosal sparing (short arrow, c), cases complicated by toxic megacolon will also demonstrate transmural abnormalities.

The size of the liver varies, depending on the degree of ®brosis, in¯ammation, and steatosis, from a small, shrunken, and hard liver to a large organ weighing up to 4 kg. Microscopically, scar tissue distorts the normal architecture of the liver by forming bands of connective tissue joining portal and central zones (Fig. 3). At ®rst, nodules are regular in size and shape. In more advanced cirrhosis, some nodules become larger and irregular. One of the most characteristic features of cirrhosis is the change in the hepatic blood circulation.

Copyright 2002 John Wiley. This material is used by permission of John Wiley & Sons, Inc. suppressed Gd T1-W spin echo (b, c) images in a patient with ulcerative colitis complicated by toxic megacolon. Precontrast, there are low-signal-intensity strands in the pericolonic fat (arrows, a). After contrast, there is intense enhancement of the sigmoid colon (asterisks, b, c) and vasa rectae (long arrows, b, c). Though a feature of ulcerative colitis is submucosal sparing (short arrow, c), cases complicated by toxic megacolon will also demonstrate transmural abnormalities.

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