Clinical study on volumetric variation of liver and spleen in liver fibrosis and cirrhosis / 中华消化杂志

ABSTRACT

Objective To assess the volumetric variation of liver and spleen in early diagnosis of liver fibrosis and cirrhosis.Methods One hundred and thirty-seven subjects underwent dynamic enhanced examination of liver and spleen using multi-slice CT(MSCT).Forty potential living liver donors were served as controls.Sixty-three histologically proved fibrotic patients were divided into slight liver fibrosis(F≤2,n=44)and advanced liver fibrosis(F≥3,n=19)according to the Ishak system.Liver cirrhosis group consisted of 34 patients diagnosed clinically and radiologically.The measurement of total liver volume(TLV),right liver lobe volume(RV),left lateral liver segment volume(LLV),left medial liver segment volume(LMV),eaudate lobe volume(CV)and spleen volume(SV)were obtained bv MSCT.The ratios of segmental liver and SV to TLV were also calculated.Results The values of liver volumes(TLV,RV and LMV)reduced gradually among control(1470.38 cm3,933.34 cm3,216.20 cm3,respectively),slight liver fibrosis(1239.99 cm3,799.74 cm3,184.69 cm3,respectively),advanced liver fibrosis(1219.76 cm3,765.22 cm3,179.44 cm3,respectively)and cirrhosis(1078.21 cm3,543.73 cm3,163.12 cm3,respectively) groups.The volume of SV and the ratios of CV/TLV and SV/TLV increased gradually among control (256.29 cm3,3.09%,17.53%),slight liver fibrosis(284.41 cm3,3.20%,22.91%),advanced liver fibrosis(343.13 cm3,3.58%,28.80%)and cirrhosis(863.38 cm3,4.16%,82.91%)groups.There was significant difference among control,liver fibrosis and cirrhosis group in TLV,RV,LMV and SV/TLV(P＜0.05),but there was no significant difference in all parameters between the slight liver fibrosis group and the advanced liver fibrosis group(P＞0.05).There was significant correlation of TLV,LMV,SV,RV,CV/TLV,SV/TLV,RV/TLV and LLV/TLV with liver cirrhosis and its staging.Conclusion Variations in liver and spleen volume,the ratios of segmental liver and SV/TLV are correlated with the extent of liver fibrosis and cirrhosis.which will be helpful in early detection of liver fibrosis and cirrhosis.