Noninvasive Assessment of Advanced Fibrosis Based on Hepatic Volume in Patients with Nonalcoholic Fatty Liver Disease

Abstract

Background/AimsNoninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the hepatic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD.MethodsA total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diagnosing fibrosis ≥F3–4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify variables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio.ResultsThe L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confidence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associated with the L/R ratio (coefficient, 0.121; p<0.0001).ConclusionsThe L/R ratio, which is not influenced by pathological parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD.

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“…Suzuki et al reported the usefulness of the spleen volume as a marker of early‐stage NASH. Hayashi et al demonstrated the usefulness of hepatic volume parameters including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio) for diagnosing cirrhosis in patients with NAFLD.…”

Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy

“…Nonalcoholic fatty liver disease was defined as the presence of fatty liver in abdominal imaging, a history of daily alcohol intake less than 20 g/day and exclusion of viral hepatitis, systemic autoimmune diseases, and metabolic diseases. 14 , 15 The diagnosis of LC was based on abdominal imaging findings, liver histology and/or clinical signs of portal hypertension such as the presence of ascites, esophageal or gastric varices, and hepatic encephalopathy. 16 - 18 The patient information collected for the study included data regarding age, sex, laboratory findings such as serum albumin, total bilirubin, prothrombin time, and platelet counts, Child-Pugh (CP) scores, number, size, and location of the polyps, underlying diseases (diabetes mellitus, hypertension, dyslipidemia, coronary heart disease, cerebrovascular disease, and chronic kidney disease), and whether the patient was taking concomitant antiplatelet and/or anticoagulant medications such as aspirin, clopidogrel, ticagrelor, cilostazol, heparin, low molecular weight heparin, warfarin, or a new oral anticoagulant.…”

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