华西医院李真林 Quantitative assessment of the presence and severity of cirrhosis in patients with hepatitis B using right liver lobe volume and spleen size measured at magnetic resonance imaging.

PLoS One. 2014 Mar 4;9（3）:e89973. doi: 10.1371/journal.pone.0089973. eCollection 2014.

Quantitative assessment of the presence and severity of cirrhosis in patients with hepatitis B using right liver lobe volume and spleen size measured at magnetic resonance imaging.

Chen XL¹, Chen TW², Zhang XM², Li ZL³, Zeng NL², Li T², Wang D², Li J², Fang ZJ³, Li H², Chen J⁴, Liu J⁵, Xu GH⁶, Ren J⁶, Wu JL⁷, Li CP².

Author information

• ¹Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China;      Department of Radiology, Sichuan Cancer Hospital and Institute & The Second People's Hospital of Sichuan Province, Chengdu, Sichuan, China.

• ²Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

• ³Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

• ⁴Department of Ultrasonography, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.

• ⁵Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.

• ⁶Department of Radiology, Sichuan Cancer Hospital and Institute & The Second People's Hospital of Sichuan Province, Chengdu, Sichuan, China.

• ⁷Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China.

Abstract

OBJECTIVE:

To determine whether right liver lobe volume （RV） and spleen size measured utilizing magnetic resonance （MR） imaging could identify the presence and severity of cirrhosis in patients with hepatitis B.

METHODS:

Two hundred and five consecutive patients with clinically confirmed diagnosis of cirrhosis due to hepatitis B and 40 healthy control individuals were enrolled in this study and underwent abdominal triphasic enhanced scans using MR imaging. Spleen maximal width （W）, thickness （T） and length （L）, together with RV and spleen volume （SV）, were measured utilizing MR imaging. Spleen multidimensional index （SI） was obtained by multiplying previously acquired parameters W×T×L. Then statistical assessment was performed to evaluate the ability of these parameters, including RV, SV, RV/SV and SI, to identify the presence of cirrhosis and define Child-Pugh class of this disease.

RESULTS:

SV and SI tended to increase （r = 0.557 and 0.622, respectively; all P<0.001）, and RV and RV/SV tended to decrease （r = -0.749 and -0.699, respectively; all P<0.001） with increasing Child-Pugh class of cirrhosis. All the parameters, including RV, SV, RV/SV and SI, might be the indicators used to discriminate the patients with liver cirrhosis from the control group, and to distinguish these patients between Child-Pugh class A and B, between B and C, and between A and C （area under receiver operating characteristic curve [AUC] = 0.609-0.975, all P<0.05）. Among these parameters, RV/SV was the best noninvasive factor for the discrimination of liver cirrhosis between Child-Pugh class A and B （AUC = 0.725）, between A and C （AUC = 0.975）, and between B and C （AUC = 0.876）, while SI was the best variable to distinguish the cirrhosis patients from the control group （AUC = 0.960, P<0.05）.

CONCLUSION:

RV/SV should be used to identify the severity of cirrhosis, while SI can be recommended to determine the presence of this disease.

PMID:24594920PMCID:PMC3942406DOI: 10.1371/journal.pone.0089973