Value of Volumetric and Morphological Parameters on Computed Tomography for Assessing Severity of Viral-Induced Liver Cirrhosis
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Value of Volumetric and Morphological Parameters on Computed Tomography for Assessing Severity of Viral-Induced Liver Cirrhosis,MOHAMED SHERIF EL-SHARKAWY
Abstract
Aim of the Work: To assess the value of abdominal CT scoring system compared to Child-Pugh classification in determining the severity of viral-induced cirrhosis.
Material and Method: Computed tomography examina-tions of the liver of 26 patients proven positive for hepatitis B (12 patients) and C (14 patients) were reviewed. All patients are examined using 64 slice multidetector CT triphasic liver protocol. Measurements are done for liver volume index, modified caudate lobe ratio (CRL-r), splenic volume index, ascites grading, presence or absence and grading of Porto systemic collaterals, grade of contour changes, confluent fibrosis if present. Patients were assessed by Child-Pugh classification in the same week of CT examination. Excluded from this study those who had end stage shrunken liver or those with focal hepatic lesions on CT. Results are statistically studied using Cohen's Kappa coefficient for measurement of agreement for quantitative items.
Results: We found substantial agreement between clinical (Child-Pugh classification) and the measured CT values (except C/RL-r) as the measurement of agreement of Kappa were equal to 0.61 and p<0.0001. Based on CT data, patients were divided into three groups (A, B, and C) and they are assessed for statistical agreement for same groups in Child-Pugh's classification A,B and C groups. Highest agreement was in the Child B group which represents 50% of the patients of the study. We found no relation between clinical stage and modified caudate-right lobe ratio (CRL-r) as rs=0.293 and p>0.05. Also we found no relation between clinical and spleen volume index since rs=0.256 and p>0.05.
Conclusion: CT scoring based on Liver volume index well-correlate with the clinical status in viral-induced cirrhotic patients in absence of global liver atrophy and focal hepatic lesions. It can be used with good accuracy rate in follow-up and assement of treatment response.
Abbreviations:
CT = Computed Tomography.
IV = Intravenous.
MRI = Magnetic resonance imaging. C/RL = Caudate-to-right lobe ratio.
C/RL-r = Modified caudate-to-right lobe ratio.