Computed tomography findings in liver fibrosis and cirrhosis

PRINCIPLES: Computed tomography (CT) is inferior to the fibroscan and laboratory testing in the noninvasive diagnosis of liver fibrosis. On the other hand, CT is a frequently used diagnostic tool in modern medicine. The auxiliary finding of clinically occult liver fibrosis in CT scans could re...

Full description

Bibliographic Details
Main Authors: Adrian Huber, Lukas Ebner, Matteo Montani, Nasser Semmo, Kingshuk Roy Choudhury, Johannes Heverhagen, Andreas Christe
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2014-02-01
Series:Swiss Medical Weekly
Subjects:
Online Access:https://www.smw.ch/index.php/smw/article/view/1824
_version_ 1797979627665227776
author Adrian Huber
Lukas Ebner
Matteo Montani
Nasser Semmo
Kingshuk Roy Choudhury
Johannes Heverhagen
Andreas Christe
author_facet Adrian Huber
Lukas Ebner
Matteo Montani
Nasser Semmo
Kingshuk Roy Choudhury
Johannes Heverhagen
Andreas Christe
author_sort Adrian Huber
collection DOAJ
description PRINCIPLES: Computed tomography (CT) is inferior to the fibroscan and laboratory testing in the noninvasive diagnosis of liver fibrosis. On the other hand, CT is a frequently used diagnostic tool in modern medicine. The auxiliary finding of clinically occult liver fibrosis in CT scans could result in an earlier diagnosis. The aim of this study was to analyse quantifiable direct signs of liver remodelling in CT scans to depict liver fibrosis in a precirrhotic stage. METHODS: Retrospective review of 148 abdominal CT scans (80 liver cirrhosis, 35 precirrhotic fibrosis and 33 control patients). Fibrosis and cirrhosis were histologically proven. The diameters of the three main hepatic veins were measured 1–2 cm before their aperture into the inferior caval vein. The width of the caudate and the right hepatic lobe were divided, and measured horizontally at the level of the first bifurcation of the right portal vein in axial planes (caudate-right-lobe ratio). A combination of both (sum of liver vein diameters divided by the caudate-right lobe ratio) was defined as the ld/crl ratio. These metrics were analysed for the detection of liver fibrosis and cirrhosis. RESULTS: An ld/crl-r <24 showed a sensitivity of 83% and a specificity of 76% for precirrhotic liver fibrosis. Liver cirrhosis could be detected with a sensitivity of 88% and a specificity of 82% if ld/crl-r <20. CONCLUSION: An ld/crl-r <24 justifies laboratory testing and a fibroscan. This could bring forward the diagnosis and patients would profit from early treatment in a potentially reversible stage of disease.
first_indexed 2024-04-11T05:41:40Z
format Article
id doaj.art-c7294b6b3adf4e95b8bf0b88037cd299
institution Directory Open Access Journal
issn 1424-3997
language English
last_indexed 2024-04-11T05:41:40Z
publishDate 2014-02-01
publisher SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
record_format Article
series Swiss Medical Weekly
spelling doaj.art-c7294b6b3adf4e95b8bf0b88037cd2992022-12-22T04:42:31ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-02-01144070810.4414/smw.2014.13923Computed tomography findings in liver fibrosis and cirrhosisAdrian HuberLukas EbnerMatteo MontaniNasser SemmoKingshuk Roy ChoudhuryJohannes HeverhagenAndreas Christe PRINCIPLES: Computed tomography (CT) is inferior to the fibroscan and laboratory testing in the noninvasive diagnosis of liver fibrosis. On the other hand, CT is a frequently used diagnostic tool in modern medicine. The auxiliary finding of clinically occult liver fibrosis in CT scans could result in an earlier diagnosis. The aim of this study was to analyse quantifiable direct signs of liver remodelling in CT scans to depict liver fibrosis in a precirrhotic stage. METHODS: Retrospective review of 148 abdominal CT scans (80 liver cirrhosis, 35 precirrhotic fibrosis and 33 control patients). Fibrosis and cirrhosis were histologically proven. The diameters of the three main hepatic veins were measured 1–2 cm before their aperture into the inferior caval vein. The width of the caudate and the right hepatic lobe were divided, and measured horizontally at the level of the first bifurcation of the right portal vein in axial planes (caudate-right-lobe ratio). A combination of both (sum of liver vein diameters divided by the caudate-right lobe ratio) was defined as the ld/crl ratio. These metrics were analysed for the detection of liver fibrosis and cirrhosis. RESULTS: An ld/crl-r <24 showed a sensitivity of 83% and a specificity of 76% for precirrhotic liver fibrosis. Liver cirrhosis could be detected with a sensitivity of 88% and a specificity of 82% if ld/crl-r <20. CONCLUSION: An ld/crl-r <24 justifies laboratory testing and a fibroscan. This could bring forward the diagnosis and patients would profit from early treatment in a potentially reversible stage of disease. https://www.smw.ch/index.php/smw/article/view/1824Liver fibrosis and cirrhosisabdominal computed tomographyhepatic vein diametercaudate right lobe ratio
spellingShingle Adrian Huber
Lukas Ebner
Matteo Montani
Nasser Semmo
Kingshuk Roy Choudhury
Johannes Heverhagen
Andreas Christe
Computed tomography findings in liver fibrosis and cirrhosis
Swiss Medical Weekly
Liver fibrosis and cirrhosis
abdominal computed tomography
hepatic vein diameter
caudate right lobe ratio
title Computed tomography findings in liver fibrosis and cirrhosis
title_full Computed tomography findings in liver fibrosis and cirrhosis
title_fullStr Computed tomography findings in liver fibrosis and cirrhosis
title_full_unstemmed Computed tomography findings in liver fibrosis and cirrhosis
title_short Computed tomography findings in liver fibrosis and cirrhosis
title_sort computed tomography findings in liver fibrosis and cirrhosis
topic Liver fibrosis and cirrhosis
abdominal computed tomography
hepatic vein diameter
caudate right lobe ratio
url https://www.smw.ch/index.php/smw/article/view/1824
work_keys_str_mv AT adrianhuber computedtomographyfindingsinliverfibrosisandcirrhosis
AT lukasebner computedtomographyfindingsinliverfibrosisandcirrhosis
AT matteomontani computedtomographyfindingsinliverfibrosisandcirrhosis
AT nassersemmo computedtomographyfindingsinliverfibrosisandcirrhosis
AT kingshukroychoudhury computedtomographyfindingsinliverfibrosisandcirrhosis
AT johannesheverhagen computedtomographyfindingsinliverfibrosisandcirrhosis
AT andreaschriste computedtomographyfindingsinliverfibrosisandcirrhosis