Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Ozaki, Kumi; Matsui, Osamu; Kobayashi, Satoshi; Minami, Tetsuya; Kitao, Azusa; Gabata, Toshifumi

doi:10.1259/bjr.20150896

Cited by 39 publications

(37 citation statements)

References 27 publications

(58 reference statements)

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“…Discrepancies between studies might be due to differences in disease aetiology; some diseases might exhibit heterogeneity in liver fibrosis (Goldstein et al 2005). In one study, morphometric changes caused by cirrhosis associated with all aetiologies commonly exhibited atrophy of the medial and anterior segments and right lobe and hypertrophy of the lateral segment and caudate lobe (Ozaki et al 2016). Finally, the standardization of maximum intercostal probe pressure with a robot force-controlled method (Bell et al 2016) would not improve reliability because the SCD differs in every patient, and different conditions of subcutaneous fat cause the ultrasound waves to attenuate differently (Mast et al 1999).…”

Section: Discussionmentioning

confidence: 99%

Influence of Probe Pressure on Ultrasound-Based Shear Wave Elastography of the Liver Using Comb-Push 2-D Technology

Byenfeldt

Elvin

Fransson

2019

Ultrasound in Medicine & Biology

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It has been postulated that in the liver, applying increased probe pressure during ultrasound-based shear wave elastography (SWE) might lead to a false increase in the SWE result. We aimed to determine the influence of increased intercostal probe pressure when performing SWE of the liver. We also investigated the number of measurements required to achieve technically successful and reliable SWE examinations. This prospective, clinical study included 112 patients and 2240 SWE measurements of the liver. We applied probe pressure intercostally, to reduce the skin-to-liver capsule distance (SCD), which could stabilize the SWE signal and thus increase the number of technically successful measurements. We performed 10 measurements with maximum probe pressure and 10 with normal pressure in each patient. Thus, two analysis groups were compared for differences. Compared with normal pressure, maximum probe pressure significantly reduced the SCD (p < 0.001) and significantly increased the number of technically successful measurements from 981 to 1098, respectively (p < 0.001). The SWE results with normal and maximum probe pressure were 5.96 kPa (interquartile range: 2.41) and 5.45 kPa (interquartile range: 1.96), respectively (p < 0.001). In obese patients, a large SCD poses a diagnostic challenge for ultrasound SWE. We found that maximum intercostal probe pressure could reduce the SCD and increase the number of technically successful measurements, without falsely increasing the SWE result. Only three measurements were required to achieve technically successful and reliable SWE examinations.

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Section: Discussionmentioning

confidence: 99%

Influence of Probe Pressure on Ultrasound-Based Shear Wave Elastography of the Liver Using Comb-Push 2-D Technology

Byenfeldt

Elvin

Fransson

2019

Ultrasound in Medicine & Biology

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“…Liver volume increases or decreases according to the clinical course of various liver diseases. For example, marked atrophy is observed in acute liver failure [13][14][15], whereas hepatomegaly is prevalent in alcoholic hepatitis [16,17]. In general, liver volume decreases in advanced cirrhosis, a final form of liver fibrosis as a consequence of long lasting liver damage and scarring [18].…”

Section: Introductionmentioning

confidence: 99%

Improved liver function in patients with cirrhosis due to chronic hepatitis C virus who achieve sustained virologic response is not accompanied by increased liver volume

et al. 2020

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Background Serum albumin level improves in patients with chronic hepatitis C virus (HCV) infection who achieve sustained virologic response (SVR) with antiviral therapy. However, it remains controversial whether liver volume increases along with SVR. Methods Patients with chronic HCV infection with a history of hepatocellular carcinoma (HCC) who achieved SVR with anti-HCV treatment from March 2003 to November 2017 were enrolled. Patients were followed up with periodic computed tomography (CT) scans to detect HCC recurrence. Patients who underwent treatment for HCC recurrence within 1 year after initiation of anti-HCV treatment were excluded. Laboratory data, including alanine aminotransferase (ALT) level, serum albumin level, and platelet count, were collected at baseline and timepoints after treatment initiation. Liver volume was evaluated at baseline and 24 and 48 weeks after treatment initiation using a CT volume analyzer. A linear mixed-effects model was applied to analyze the chronologic change in liver volume. The correlations between changes in ALT level, albumin level, and liver volume were also evaluated. Results Of 108 enrolled patients, 78 had cirrhosis. Serum albumin level continued to increase through 48 weeks after treatment initiation. A significant increase in liver volume was observed only in patients without cirrhosis (P = 0.005). There was a significant correlation between ALT level decrease and albumin level increase (P = 0.018).

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“…However, a strong correlation was observed between fibrosis stage and the volume percentage of the caudate lobe in our study. Ozaki et al[12] recently reported that hypertrophy of the caudate lobe progressed more in alcoholism and NASH patients than in virus-related etiologies in patients with liver cirrhosis, Child-Pugh Class A. It was also reported that enlargement of the caudate lobe was a more frequent finding in alcoholic cirrhosis than virus-induced cirrhosis[13].…”

Section: Discussionmentioning

confidence: 99%

Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry

Fujita

Nishie

Asayama

et al. 2016

WJG

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AIMTo evaluate the diagnostic performance of computed tomography (CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD).METHODSA total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment (LLS), left medial segment, caudate lobe, and right lobe (RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman’s rank correlation coefficient. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.RESULTSThe volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage (r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage (r = -0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis (F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.CONCLUSIONThe volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.

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Morphometric changes in liver cirrhosis: aetiological differences correlated with progression

Cited by 39 publications

References 27 publications

Influence of Probe Pressure on Ultrasound-Based Shear Wave Elastography of the Liver Using Comb-Push 2-D Technology

Influence of Probe Pressure on Ultrasound-Based Shear Wave Elastography of the Liver Using Comb-Push 2-D Technology

Improved liver function in patients with cirrhosis due to chronic hepatitis C virus who achieve sustained virologic response is not accompanied by increased liver volume

Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry

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