Hess C F, Schmiedl U, Koelbel G, Knecht R, Kurtz B
Department of Radiology, School of Medicine, University of Tuebingen, Federal Republic of Germany.
Radiology. 1989 May;171(2):349-51. doi: 10.1148/radiology.171.2.2649915.
To assess the utility of changes in the volume of the caudate lobe in the sonographic diagnosis of liver cirrhosis, the authors studied 58 patients with histologically proved cirrhosis, 18 patients with fatty liver, 28 patients with liver metastases, seven patients with lymphomatous liver involvement, and 75 healthy individuals. The longitudinal (CL), transverse (CT), and anteroposterior (CAP) diameters of the caudate lobe and the transverse diameter of the right lobe (RL) were measured, and one-, two-, and three-dimensional caudate lobe indexes and ratios were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic curves, revealed that the ratio of the three-dimensional caudate index (CI3) to the right lobe diameter (CI3/RL = [CL X CT X CAP]/RL) was superior to all other calculated criteria. At a specificity of 95%, the sensitivity of CI3/RL was 94.7%, compared with 73.3% for CT/RL. No significant differences were found between the control group and patients with fatty liver, metastases, or lymphomatous involvement. The study suggests that CI3/RL is the most reliable quantitative criterion for the US diagnosis of liver cirrhosis.
为评估尾状叶体积变化在肝硬化超声诊断中的效用，作者对58例经组织学证实为肝硬化的患者、18例脂肪肝患者、28例肝转移患者、7例淋巴瘤肝受累患者及75名健康个体进行了研究。测量了尾状叶的纵径（CL）、横径（CT）和前后径（CAP）以及右叶的横径（RL），并计算了一维、二维和三维尾状叶指数及比值。通过受试者操作特征曲线比较这些标准的诊断性能分析显示，三维尾状叶指数（CI3）与右叶直径的比值（CI3/RL = [CL×CT×CAP]/RL）优于所有其他计算标准。在特异性为95%时，CI3/RL的敏感性为94.7%，而CT/RL为73.3%。在对照组与脂肪肝、转移瘤或淋巴瘤受累患者之间未发现显著差异。该研究表明，CI3/RL是超声诊断肝硬化最可靠的定量标准。
