Jehangir Maham, Nazir Rashed, Jang Aisha, Rana Atif, Rafique Salman, Dar Faisal Saud
Department of Radiology, Shifa International Hospital, Islamabad, Pakistan.
Department of Gastroenterology and Liver Transplant, Shifa International Hospital, Islamabad, Pakistan.
Clin Transplant. 2016 Sep;30(9):1016-20. doi: 10.1111/ctr.12782. Epub 2016 Jul 2.
Hepatic steatosis threatens post-transplant graft survival; therefore, pre-operative quantification of steatosis is crucial. Gold standard for evaluation is donor liver biopsy but it is invasive. An alternative non-invasive method is a calculation of CT liver attenuation index. BMI can be an independent factor predicting grade of steatosis but it is necessary to re-define appropriate BMI cut-off points that are specific for Asians.
To retrospectively analyze CT LAI and BMI for quantitative assessment of macrovesicular steatosis in living related liver donors, using histological analysis as gold standard.
A radiologist blinded to histological grading calculated mean CT hepatic attenuation in 48 potential living related liver donors.
CT-derived LAI correctly predicted steatosis in all except 1 patient. Parametric analysis for CT LAI and BMI showed overall weak positive correlation. No significant association was found between BMI and biopsy findings.
Liver biopsy remains a gold standard for evaluation of steatosis. CT LAI of ≤0 correlates well with significant hepatic steatosis and biopsy may be avoided in such cases. Biopsy may be reserved for patients with CT LAI between 1 and 5. BMI alone is not a good predictor of hepatic steatosis in our study population.
肝脂肪变性会威胁移植后移植物的存活；因此，术前对脂肪变性进行量化至关重要。评估的金标准是供体肝活检，但它具有侵入性。一种替代的非侵入性方法是计算CT肝脏衰减指数。BMI可能是预测脂肪变性分级的独立因素，但有必要重新定义适合亚洲人的合适BMI切点。
以组织学分析作为金标准，回顾性分析CT肝脏衰减指数（CT LAI）和BMI对活体亲属肝供体中重度脂肪变性的定量评估。
一名对组织学分级不知情的放射科医生计算了48名潜在活体亲属肝供体的平均CT肝脏衰减值。
除1例患者外，CT衍生的LAI正确预测了脂肪变性。对CT LAI和BMI的参数分析显示总体呈弱正相关。未发现BMI与活检结果之间存在显著关联。
肝活检仍然是评估脂肪变性的金标准。CT LAI≤0与显著肝脂肪变性相关性良好，在此类情况下可避免活检。活检可保留给CT LAI在1至5之间的患者。在我们的研究人群中，单独BMI并不是肝脂肪变性的良好预测指标。
