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The Role of Liver Segment-to-Spleen Volume Ratio in the Staging of Hepatic Fibrosis in Patients with Hepatitis C Virus Infection.
Lotan, Eyal; Raskin, Stephen P; Amitai, Michal M; Kleinbaum, Yeruham; Veitsman, Ella; Weiss, Peretz; Cohen-Ezra, Oranit; Berdichevski, Tania; Ben-Ari, Ziv.
Afiliación
  • Lotan E; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
  • Raskin SP; Borenstein Talpiot Medical Leadership Program, 2013, Sheba Medical Center, Tel Hashomer, Israel.
  • Amitai MM; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Kleinbaum Y; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
  • Veitsman E; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
  • Weiss P; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Cohen-Ezra O; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
  • Berdichevski T; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Ben-Ari Z; Department of Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel.
Isr Med Assoc J ; 19(4): 251-256, 2017 Apr.
Article en En | MEDLINE | ID: mdl-28480681
BACKGROUND: Accurate assessment of liver fibrosis is crucial for the management of patients with hepatitis C virus (HCV) infection. OBJECTIVES: To evaluate the performance of liver segment-to-spleen volume ratio in predicting the severity of liver fibrosis. METHODS: Sixty-four consecutive HCV patients were enrolled in this retrospective study. All patients underwent contrast-enhanced computed tomography (CT) and were divided into three groups based on their hepatic fibrosis stage evaluated by shear-wave elastography (SWE): non-advanced (F0-F1, n=29), advanced (F2, n=19) and severe fibrosis (F3-F4, n=16). Using semi-automated liver segmentation software, we calculated the following liver segments and spleen volumes for each participant: total liver volume (TLV), caudate lobe (CV), left lateral segment (LLV), left medial segment (LMV), right lobe (RV) and spleen (SV), a well as their ratios: CV/SV, RV/SV, LLV/SV, LMV/SV and TLV/SV. RESULTS: RV/SV was found to discriminate between patients with non-advanced and advanced fibrosis (P = 0.001), whereas SV, CV, RV, TLV/SV, LMV/SV and RV/SV discriminated between patients with advanced and severe fibrosis (P < 0.05). RV/SV ≤ 3.6 and RV ≤ 2.9 were identified as the best cutoff values to differentiate non-advanced from advanced fibrosis and advanced from severe fibrosis with sensitivities of 72.2% and 92.7%, specificities of 72.7% and 77.8%, and with an area under the receiver operating characteristic (ROC) curve of 0.797 and 0.847, respectively (P ≤ 0.002). CONCLUSIONS: RV/SV may be used for the assessment and monitoring of liver fibrosis in HCV patients prior to the administration of antiviral therapy, considering SWE as the reference method.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Bazo / Hepatitis C / Hígado / Cirrosis Hepática Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Isr Med Assoc J Asunto de la revista: MEDICINA Año: 2017 Tipo del documento: Article País de afiliación: Israel Pais de publicación: Israel
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antivirales / Bazo / Hepatitis C / Hígado / Cirrosis Hepática Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Isr Med Assoc J Asunto de la revista: MEDICINA Año: 2017 Tipo del documento: Article País de afiliación: Israel Pais de publicación: Israel