Assessment of liver volume variation to evaluate liver function

Abstract

In order to assess the value of liver volumetry in cirrhosis and acute liver failure (ALF) patients, we explored the correlation between hepatic volume and severity of the hepatic diseases. The clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were collected. Computed tomography-derived liver volume (CTLV) and body surface area (BSA) of normal controls were calculated to get a regression formula for standard liver volume (SLV) and BSA. Then CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further comparison. It turned out that the mean liver volume of the control group was 1 058±337 cm³. SLV was correlated with BSA according to the regression formula. The hepatic volume of cirrhosis patients in Child A, B level was not reduced, but in Child C level it was significantly reduced with the lowest liver volume index (CTLV/SLV). Likewise, in the death group of ALF patients, the volume index was significantly lower than that of the survival group. Based on volumetric study, we proposed an ROC (receiver operating characteristic) analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor prognosis. In conclusion, the CTLV/SLV ratio, which reflects liver volume variations, correlates well with the liver function and progression of cirrhosis and ALF. It is also a very useful marker for predicting the prognosis of ALF.

Keywords

liver volume variation / cirrhosis / acute liver failure (ALF)

References

[1] Saygili OB, Tarhan NC, Yildirim T, Serin E, Ozer B, Agildere AM. Value of computed tomography and magnetic resonance imaging for assessing severity of liver cirrhosis secondary to viral hepatitis. Eur J Radiol2005; 54(3): 400–407

[2] Sekiyama K, Yoshiba M, Inoue K, Sugata F. Prognostic value of hepatic volumetry in fulminant hepatic failure. Dig Dis Sci1994; 39(2): 240–244

[3] Vauthey JN, Abdalla EK, Doherty DA, Gertsch P, Fenstermacher MJ, Loyer EM, Lerut J, Materne R, Wang X, Encarnacion A, Herron D, Mathey C, Ferrari G, Charnsangavej C, Do KA, Denys A. Body surface area and body weight predict total liver volume in Western adults. Liver Transpl2002; 8(3): 233–240

[4] Chinese Medical Association. Viral Hepatitis Prevention and Treatment Scheme in China. Chin J Hepatol (Zhonghua Gan Zang Bing Za Zhi)2000; 8(6): 324–329 (in Chinese)

[5] Heymsfield SB, Fulenwider T, Nordlinger B, Barlow R, Sones P, Kutner M. Accurate measurement of liver, kidney, and spleen volume and mass by computerized axial tomography. Ann Intern Med1979; 90(2): 185–187

[6] Kardel T, Holm HH, Rasmussen SN, Mortensen T. Ultrasonic determination of liver and spleem volumes. Scand J Clin Lab Invest1971; 27(2): 123–128

[7] Kalkmann J, Forsting M, Stattaus J. Liver volume variations as a parameter to assess therapy response in advanced metastatic liver disease. Onkologie2011; 34(1-2): 30–34

[8] Dubus L, Gayet M, Zappa M, Abaleo L, De Cooman A, Orieux G, Vilgrain V. Comparison of semi-automated and manual methods to measure the volume of liver tumours on MDCT images. Eur Radiol2011; 21(5): 996–1003

[9] Müller SA, Bläuer K, Kremer M, Thorn M, Mehrabi A, Meinzer HP, Hinz U, Metzger J, Büchler MW, Schmied BM. Exact CT-based liver volume calculation including nonmetabolic liver tissue in three-dimensional liver reconstruction. J Surg Res2010; 160(2): 236–243

[10] Zhou XP, Lu T, Wei YG, Chen XZ. Liver volume variation in patients with virus-induced cirrhosis: findings on MDCT. AJR Am J Roentgenol2007; 189(3): W153-159

[11] Du WB, Pan XP, Li LJ. Prognostic models for acute liver failure. Hepatobiliary Pancreat Dis Int2010; 9(2): 122–128

[12] Li YM, Lv F, Xu X, Ji H, Gao WT, Lei TJ, Ren GB, Bai ZL, Li Q. Evaluation of liver functional reserve by combining D-sorbitol clearance rate and CT measured liver volume. World J Gastroenterol2003; 9(9): 2092–2095

[13] Tu R, Xia LP, Yu AL, Wu L. Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT. World J Gastroenterol2007; 13(29): 3956–3961

[14] Joyeux H, Berticelli J, Chemouny S, Masson B, Borianne P. Semi-automatic measurements of hepatic lobes. Application to study of liver volumes. Analysis of 50 computed tomography of normal liver. Ann Chir2003; 128(4): 251–255 (in French)

[15] Dodd GD 3rd, Baron RL, Oliver JH 3rd, Federle MP. Spectrum of imaging findings of the liver in end-stage cirrhosis: Part II, focal abnormalities. AJR Am J Roentgenol1999; 173(5): 1185–1192

[16] Wang JH, Changchien CS, Hung CH, Eng HL, Tung WC, Kee KM, Chen CH, Hu TH, Lee CM, Lu SN. FibroScan and ultrasonography in the prediction of hepatic fibrosis in patients with chronic viral hepatitis. J Gastroenterol2009; 44(5): 439–446

[17] Shim JH, Yu JS, Chung JJ, Kim JH, Kim KW. Segmental difference of the hepatic fibrosis from chronic viral hepatitis due to hepatitis B versus C virus infection: comparison using dual contrast material-enhanced MRI. Korean J Radiol2011; 12(4): 431–438

[18] Krinsky GA, Lee VS, Theise ND. Focal lesions in the cirrhotic liver: high resolution ex vivo MRI with pathologic correlation. J Comput Assist Tomogr2000; 24(2): 189–196

[19] Shakil AO, Jones BC, Lee RG, Federle MP, Fung JJ, Rakela J. Prognostic value of abdominal CT scanning and hepatic histopathology in patients with acute liver failure. Dig Dis Sci2000; 45(2): 334–339

RIGHTS & PERMISSIONS

2014 Higher Education Press and Springer-Verlag Berlin Heidelberg