| Background&ObjectivePost-hepatitis B cirrhosis is the terminal stage of liver fibrosis.The severity of liver cirrhosis and the status of liver function in patients with post-hepatitis B cirrhosis are very important for their survival and prognosis.In terms of assessment of liver fibrosis,liver biopsy is the gold standard;when it comes to assessment of liver function,cirrhosis is divided into decompensated and decompensated phases according to the existence of its complications.Also,Child-Pugh grade and MELD Score,are the long-standing ways for assessing liver function status,which are validated by practices.However,the methods mentioned above are more or less deficient,so new ways are needed to better assess the degree of liver cirrhosis and liver function in patients with post-hepatitis B cirrhosis.Among a variety of evaluation methods reported in the literature in recent years,the multi-slice spiral CT is featured with accurate measurement of liver volume,while change of liver volume is one of the most basic pathologic changes in various pathological changes of livers in post-hepatitis B cirrhosis.However,what the correlation between change of liver volume and histological changes and functional changes is,and whether it can be used as a quantitative indicator to diagnose the severity of liver cirrhosis,is unclear because few literatures are for this area.Moreover,most of them lack the synchronous histopathology grading content in the design of the studies.In this study,the relationship between CT liver volume and histopathological grade,clinical stage,Child-Pugh grade and MELD score were evaluated,in order to assess the value of liver volume measured by CT in quantitative diagnosis of degree of cirrhosis and liver function.MethodsPatients with post-hepatitis B cirrhosis who were hospitalized at Nanfang Hospital of Southern Medical University from January 2012 to June 2014 and who underwent liver biopsy during hospitalization were collected.After selection with inclusion criteria and exclusion criteria,30 patients were eligible for the study.The clinical data collected included albumin,alanine aminotransferase,aspartate aminotransferase,the international normalized ratio of prothrombin time,platelet count,and serum creatinine.1 week before biopsy,endoscopic gastroscopy was taken to know whether there’s esophageal varices,and abdominal B-mode ultrasound to know whether there’s ascites.Also,1 week before biopsy,patients were performed with 64-slice spiral CT scan and three-phase enhanced scan.Then the CT data were imported into Mimics 10.01 software for three-dimensional reconstruction of the liver and computed the CT liver volume.At the same time,the clinical stage of cirrhosis was assessed according to the criteria of "Baveno IV diagnosis and treatment of portal hypertension".The Child-Pugh and MELD scores were calculated within 48 hours before the biopsy.After liver biopsy,the specimen was taken and graded according to the Laennec histopathology grading criteria.The differences in CT liver volumes between the divided groups of Laennec grade,clinical stage,Child-Pugh grade,MELD score,and the correlation of the aforementioned grading/staging system with CT liver volume were analyzed.ResultCompared with the theoretical liver volume,CT liver volume in 30 patients was significantly smaller(P<0.05).There was a significant negative correlation between the change of CT liver volume and liver histopathology grade,clinical stage of liver cirrhosis and MELD score of liver function(P<0.01),with the correlation coefficient(r)of-0.55,-0.78 and-0.52,respectively;no significant correlation was found between CT liver volume and the Child-Pugh grade(r=-0.34).There were significant differences in the liver volume between the divided groups of Laennec grade.clinical stage,Child-Pugh grade and MELD score(P<0.05),respectively.There was no significant difference in liver volume between the groups of Child-Pugh A and B(P>0.05).ConclusionCT liver volume in patients with post-hepatitis B can be used as a quantitative diagnostic and evaluation index for the degree of cirrhosis and functional status of liver. |
PDF Full Text Request