Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui 910-1193, Japan.
Radiological Center, University of Fukui Hospital, Japan.
Eur J Radiol. 2021 Dec;145:110033. doi: 10.1016/j.ejrad.2021.110033. Epub 2021 Nov 16.
To assess the segmental difference of liver fibrosis during the progression of chronic liver disease (CLD) using hepatic extracellular volume fractions (fECVs) obtained by dual-energy CT.
A total of 218 patients (92 men and 126 women; mean age, 67.8 ± 11.7 years) with CLD and 85 patients (44 men and 41 women; mean age, 62.8 ± 13.7 years) without CLD as a control underwent dual-energy computed tomography (CT) of the liver (5-min equilibrium phase images). The iodine densities of the lateral, medial, anterior, and posterior segments and the aorta were measured, and fECVs were calculated. Comparisons of the fECV of each segment and for each albumin-bilirubin (ALBI) grade were then statistically analyzed.
In the control group and ALBI grades 1 and 3, no significant difference in fECV was found between each segment, whereas in ALBI grade 2, the fECVs were significantly larger in the medial and anterior than in the other segments (p < 0.001). The fECVs of the lateral and posterior segments significantly increased with higher ALBI grade (p < 0.001). The fECVs of the medial and anterior segments were significantly increased with higher ALBI grade, up to grade 2 (p < 0.001), but no significant difference was found between ALBI grades 2 and 3.
During the progression of CLD, fibrosis antecedently progressed in the medial and anterior segments, followed by the other liver segments.
利用双能 CT 获得的肝细胞外体积分数（fECV）评估慢性肝病（CLD）进展过程中肝纤维化的节段差异。
共 218 例 CLD 患者（92 例男性和 126 例女性；平均年龄 67.8±11.7 岁）和 85 例无 CLD 的患者（44 例男性和 41 例女性；平均年龄 62.8±13.7 岁）作为对照，行肝脏双能 CT（5 分钟平衡期图像）检查。测量肝外侧、内侧、前侧和后侧以及主动脉的碘密度，并计算 fECV。然后对每个节段和每个白蛋白-胆红素（ALBI）分级的 fECV 进行统计学比较。
在对照组和 ALBI 分级 1 和 3 中，各节段之间的 fECV 无显著差异，而在 ALBI 分级 2 中，内侧和前侧的 fECV 显著大于其他节段（p<0.001）。外侧和后侧的 fECV 随 ALBI 分级的升高而显著增加（p<0.001）。内侧和前侧的 fECV 随 ALBI 分级的升高而显著增加，直至 ALBI 分级 2（p<0.001），但 ALBI 分级 2 和 3 之间无显著差异。
在 CLD 进展过程中，纤维化首先在前侧和内侧节段进展，然后在其他肝段进展。
