Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea.
Eur Radiol. 2020 Jun;30(6):3486-3496. doi: 10.1007/s00330-020-06665-4. Epub 2020 Feb 13.
To evaluate whether the liver and spleen volumetric indices, measured on portal venous phase CT images, could be used to assess liver fibrosis severity in chronic liver disease.
From 2007 to 2017, 558 patients (mean age 48.7 ± 13.1 years; 284 men and 274 women) with chronic liver disease (n = 513) or healthy liver (n = 45) were retrospectively enrolled. The liver volume (sVol) and spleen volume (sVol), normalized to body surface area and liver-to-spleen volume ratio (Vol/Vol), were measured on CT images using a deep learning algorithm. The correlation between the volumetric indices and the pathologic liver fibrosis stages combined with the presence of decompensation (F0, F1, F2, F3, F4C [compensated cirrhosis], and F4D [decompensated cirrhosis]) were assessed using Spearman's correlation coefficient. The performance of the volumetric indices in the diagnosis of advanced fibrosis, cirrhosis, and decompensated cirrhosis were evaluated using the area under the receiver operating characteristic curve (AUC).
The sVol (ρ = 0.47-0.73; p < .001) and Vol/Vol (ρ = -0.77-- 0.48; p < .001) showed significant correlation with liver fibrosis stage in all etiological subgroups (i.e., viral hepatitis, alcoholic and non-alcoholic fatty liver, and autoimmune diseases), while the significant correlation of sVol was noted only in the viral hepatitis subgroup (ρ = - 0.55; p < .001). To diagnose advanced fibrosis, cirrhosis, and decompensated cirrhosis, the Vol/Vol (AUC 0.82-0.88) and sVol (AUC 0.82-0.87) significantly outperformed the sVol (AUC 0.63-0.72; p < .001).
The Vol/Vol and sVol may be used for assessing liver fibrosis severity in chronic liver disease.
• Volumetric indices of liver and spleen measured on computed tomography images may allow liver fibrosis severity to be assessed in patients with chronic liver disease.
评估门静脉期 CT 图像上测量的肝脏和脾脏体积指数是否可用于评估慢性肝病的肝纤维化严重程度。
2007 年至 2017 年，回顾性纳入 558 例（平均年龄 48.7±13.1 岁；284 名男性和 274 名女性）慢性肝病（n=513）或健康肝脏（n=45）患者。使用深度学习算法在 CT 图像上测量肝脏体积（sVol）和脾脏体积（sVol），并标准化为体表面积和肝脾体积比（Vol/Vol）。使用 Spearman 相关系数评估体积指数与病理肝纤维化分期（合并失代偿：F0、F1、F2、F3、F4C[代偿性肝硬化]和 F4D[失代偿性肝硬化]）之间的相关性。使用受试者工作特征曲线下面积（AUC）评估体积指数在诊断晚期纤维化、肝硬化和失代偿性肝硬化中的性能。
sVol（ρ=0.47-0.73；p<0.001）和 Vol/Vol（ρ=-0.77--0.48；p<0.001）在所有病因亚组（即病毒性肝炎、酒精性和非酒精性脂肪性肝病、自身免疫性疾病）中与肝纤维化分期均有显著相关性，而 sVol 的显著相关性仅见于病毒性肝炎亚组（ρ=-0.55；p<0.001）。诊断晚期纤维化、肝硬化和失代偿性肝硬化时，Vol/Vol（AUC 0.82-0.88）和 sVol（AUC 0.82-0.87）显著优于 sVol（AUC 0.63-0.72；p<0.001）。
肝脾体积指数可用于评估慢性肝病的肝纤维化严重程度。
·CT 图像上测量的肝脏和脾脏体积指数可用于评估慢性肝病患者的肝纤维化严重程度。
