Cirrhosis: Modified Caudate–Right Lobe Ratio

Awaya, Hitomi; Mitchell, Donald G.; Kamishima, Tamotsu; Holland, George A.; Ito, Katsuyoshi; Matsumoto, Tsuneo

doi:10.1148/radiol.2243011495

Cited by 178 publications

(118 citation statements)

References 15 publications

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“…The mean MELD score in the patients with imaging stigmata of cirrhosis was 11.0 (SD 4.0; range [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and the mean MELD score in patients without imaging stigmata of cirrhosis was 7.3 (SD 1.3; range 5-10) (P < 0.004). Because all patients in the subgroup without imaging stigmata of cirrhosis had MELD scores 10, this subgroup was compared with a subgroup that had imaging stigmata of cirrhosis and also had MELD scores 10 (n ¼ 45).…”

Section: Mri Resultsmentioning

confidence: 99%

“…Modified caudate-right ratio, defined as the one using the right portal vein to set the lateral boundary of the caudate lobe, was demonstrated to have higher sensitivity, specificity, and accuracy for diagnosing cirrhosis as compared to caudate-right lobe ratio which uses the main portal vein to set the lateral boundary of the caudate lobe (15). Therefore, modified caudate-right lobe ratio was used in image analysis.…”

Section: Image Analysismentioning

confidence: 99%

See 1 more Smart Citation

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Chernyak

Kim

Rozenblit

et al. 2011

Magnetic Resonance Imaging

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Purpose: To identify factors influencing hepatobiliary phase (HBP) hepatic enhancement on gadoxetate disodium-enhanced MRI in patients with chronic liver disease (CLD). Materials and Methods:We retrospectively reviewed abdominal gadoxetate disodium-enhanced MRIs and medical records of patients with (n ¼ 97) and without (n ¼ 48) CLD. CLD subgroups were formed based on normal/ abnormal components of liver function tests (LFTs). Hepatic enhancement coefficients (HEKs) were calculated on MRI, and compared with LFTs and Model for Endstage Liver Disease (MELD) scores.Results: The mean HEK was significantly lower (P < 0.0008) in the CLD than control group. The mean HEK was similar to controls in the subgroup with all normal LFTs (P ¼ 0.09) and subgroup with normal direct bilirubin (DB) (p ¼ 0.09), while it was significantly reduced (P < 0.0001) in the subgroup with elevated DB. For all other LFT components, regardless of normal or abnormal values, there was a significant reduction in the mean HEKs versus controls (all P values <0.01). There was a highly negative correlation between the mean HEKs in CLD subgroups and number of abnormal LFTs (r ¼ À0.93) and MELD scores (r ¼ À0.89).Conclusion: HBP hepatic enhancement in CLD patients is similar to those with no CLD as long as direct bilirubin remains normal. Higher MELD scores and higher number of abnormal LFT components are associated with reduced hepatic enhancement.

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Section: Mri Resultsmentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Chernyak

Kim

Rozenblit

et al. 2011

Magnetic Resonance Imaging

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“…Helical and multidetector row computed tomography provide improved resolution of early morphological changes with cirrhosis (in the absence of portal hypertension) but remain unhelpful with respect to fibrosis detection. 23 Specific features on magnetic resonance imaging (MRI) including hepatic vein narrowing, 24 caudate to right lobe ratio, 25 and expanded gallbladder fossa, 26 reliably identify cirrhosis but remain absent in earlier stages of fibrosis.…”

Section: Current Methods For Detecting Hepatic Fibrosismentioning

confidence: 99%

Magnetic resonance imaging of hepatic fibrosis: Emerging clinical applications

et al. 2007

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Chronic liver disease and cirrhosis remains a major public health problem worldwide. While the majority of complications from chronic liver disease result from progressive hepatic fibrosis, the available diagnostic tests used in clinical practice are not sensitive or specific enough to detect occult liver injury at early or intermediate stages. While liver biopsy can stage the extent of fibrosis at diagnosis, its utility as a tool for longitudinal monitoring will be limited at the population level. To date, a number of methods including serum marker panels and ultrasound-based transient elastrography have been proposed for the non-invasive identification of hepatic fibrosis. Novel techniques including magnetic resonance (MR) spectroscopy, diffusion weighted MR, and MR elastography have also emerged for detecting fibrosis. In contrast to other non-invasive methods, MR imaging holds the promise of providing functional and biological information about hepatic pathophysiology as it relates to the natural history and future treatment of hepatic fibrosis. (HEPATOLOGY 2008;47:332-342.)

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“…The hepatocytes within the lobe that receives venous blood from the pancreas, stomach, and duodenum are large; those within the lobe that receives intestinal blood are small (7). In cirrhosis, changes to hemodynamic forces and preferential streaming of hepatotrophic factors are believed to play a key role in regional changes in hepatic morphology, such as hypertrophy of the caudate lobe and atrophy of the right lobe (8,9), and the same forces influence the development of collaterals (10).…”

Section: Hemodynamics and Streamlining In The Psmv Systemmentioning

confidence: 99%

Utility of cone-beam computed tomography in the assessment of the porto-spleno-mesenteric venous system

Karuppasamy

2016

Cardiovasc. Diagn. Ther.

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The common diagnostic tools available to evaluate the porto-spleno-mesenteric venous (PSMV) system provide either good hemodynamic information with limited morphological details [e.g., ultrasonography (US)] or excellent tomographic display of the anatomy with limited information about flow patterns [e.g., multidetector computed tomography (MDCT) and magnetic resonance imaging]. Although catheter-directed selective digital subtraction angiography (DSA) can provide excellent information about flow at a high temporal resolution and can generate images at a high spatial resolution, this technique is often limited by a lack of cross-sectional detail. In the assessment of the PSMV system, DSA is also limited by dilution of contrast and motion artefacts. Combining venous phase cone-beam computed tomography (CBCT) with DSA can generate high-quality tomographic data, which allows detailed evaluation of venous tributaries and flow patterns within the splenic, superior mesenteric, and inferior mesenteric venous systems individually. This enables clinicians to better understand the impact of nonobstructive resistance to flow (e.g., as in patients with cirrhosis) and obstructive resistance to flow (e.g., as in patients with thrombosis) within each system and plan treatment accordingly. In this review, we discuss the limitations of common diagnostic methods and the role venous CBCT in combination with DSA can play in assessing the PSMV system.

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Cirrhosis: Modified Caudate–Right Lobe Ratio

Abstract: C/RL-r is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is C/RL-m.

Cited by 178 publications

References 15 publications

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Magnetic resonance imaging of hepatic fibrosis: Emerging clinical applications

Utility of cone-beam computed tomography in the assessment of the porto-spleno-mesenteric venous system

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