Ye Huifen, Wang Qiushi, Huang Haitao, Zhao Ke, Li Pinxiong, Liu Zaiyi, Wang Guangyi, Liang Changhong
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Quant Imaging Med Surg. 2023 Mar 1;13(3):1499-1509. doi: 10.21037/qims-22-861. Epub 2023 Jan 9.
Early detection of liver cirrhosis is of great significance to the formulation of treatment plans and improving prognosis. Computed tomography (CT) is commonly used in the assessment of patients with chronic liver disease. In this study, we proposed a new distance ratio method for accurate diagnosis of cirrhosis using CT images.
This was a retrospective study of a consecutive series of patients in Guangdong Provincial People's Hospital. Sixty-two patients with pathologically diagnosed cirrhosis but whose morphologic changes were insufficient to diagnose cirrhosis were included in the cirrhosis group. Those who were pathologically confirmed to be free of cirrhosis and fibrosis and without a history of chronic hepatic were classified as the control group. A total of 124 patients underwent abdominal dynamic enhanced CT. Both the L-distance ratio-the ratio of the distance from the right portal vein bifurcation point to the anterior and posterior edges of the liver-and the caudate-right lobe ratio were measured by two independent radiologists. Intraclass correlation coefficients (ICCs) were used to assess the agreement between the radiologists. Binary logistic regression was performed for univariate analysis, and the odds ratio (OR) was also calculated. The discrimination ability of the two methods was evaluated by the area under the receiver operating characteristic curve (AUC).
For both the L-distance ratio and the caudate-right lobe ratio, high agreement was observed between the two radiologists, although the ICC value of the L-distance ratio was slightly higher than that of the caudate-right lobe ratio (0.916 . 0.907). Binary logistic regression suggested that higher ratios were correlated with cirrhosis [the L-distance ratio, high . low OR =4.41, 95% confidence interval (CI): 2.08-9.36, P<0.001; the caudate-right lobe ratio, high . low OR =2.19, 95% CI: 1.07-4.49, P=0.031]. The AUCs of the L-distance ratio and the caudate-right lobe ratio were 0.823 (95% CI: 0.752-0.894) and 0.663 (95% CI: 0.569-0.757), respectively.
The L-distance ratio method proposed in this paper is more simple, accurate, and reliable than the caudate-right lobe ratio method in the diagnosis of cirrhosis.
早期发现肝硬化对于制定治疗方案和改善预后具有重要意义。计算机断层扫描（CT）常用于慢性肝病患者的评估。在本研究中，我们提出了一种使用CT图像准确诊断肝硬化的新距离比方法。
这是一项对广东省人民医院连续系列患者的回顾性研究。肝硬化组纳入了62例经病理诊断为肝硬化但形态学改变不足以诊断肝硬化的患者。那些经病理证实无肝硬化和纤维化且无慢性肝病病史的患者被分类为对照组。共有124例患者接受了腹部动态增强CT检查。两位独立的放射科医生测量了L距离比（从右门静脉分叉点到肝脏前后边缘的距离之比）和尾状叶-右叶比。组内相关系数（ICC）用于评估放射科医生之间的一致性。进行二元逻辑回归进行单变量分析，并计算比值比（OR）。通过受试者操作特征曲线（AUC）下的面积评估这两种方法的辨别能力。
对于L距离比和尾状叶-右叶比，两位放射科医生之间均观察到高度一致性，尽管L距离比的ICC值略高于尾状叶-右叶比（0.916对0.907）。二元逻辑回归表明，较高的比值与肝硬化相关[L距离比，高对低OR = 4.41，95%置信区间（CI）：2.08 - 9.36，P < 0.001；尾状叶-右叶比，高对低OR = 2.19，95% CI：1.07 - 4.49，P = 0.031]。L距离比和尾状叶-右叶比的AUC分别为0.823（95% CI：0.752 - 0.894）和0.663（95% CI：0.569 - 0.757）。
本文提出的L距离比方法在肝硬化诊断中比尾状叶-右叶比方法更简单、准确和可靠。
