Liver/spleen volume ratio as a predictor of prognosis in primary biliary cirrhosis.
ABSTRACT The course of primary biliary cirrhosis (PBC) is determined by clinical symptoms and histological findings. The present study examined the prognostic importance of imaging parameters in PBC.
The volumes of the liver and spleen of patients with PBC were assessed by computed tomography (CT). The volume ratio of liver to spleen (LV/SV ratio) was evaluated and used for further analyses.
The prognosis was significantly poorer in PBC patients with a low, rather than high, LV/SV ratio. The Cox proportional hazard regression model showed that the serum bilirubin level and the LV/SV ratio could predict the prognosis of PBC patients. In addition, the LV/SV ratio was significantly lower in patients who developed symptoms (s-PBC) than in those who remained asymptomatic (a-PBC) during the observation period.
The LV/SV ratio is of prognostic importance in patients with PBC.
- SourceAvailable from: Marco Arrese
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- "In order to perform a morphological analysis, the liver and the spleen volumes that are typically used as indirect radiological marker for PH diagnosis   were quantified. For the liver volume (LV) estimation a 3D Inversion Recovery sequence was used with the following parameters: FOV = 400 × 400 × 180 mm, acquisition matrix = 672 × 672 resulting in a 0.6 × 0.6 mm in-plane spatial resolution, slice thickness = 3 mm, TR/TE = 4.3/1.34 "
ABSTRACT: To investigate the feasibility of estimating the portal vein blood volume that flows into the intrahepatic volume (IHPVBV) in each cardiac cycle using non-contrast MR venography technique as a surrogate marker of portal hypertension (PH). Ten patients with chronic liver disease and clinical symptoms of PH (40% males, median age:54.0, range:44-73y.o.) and ten healthy volunteers (80% males, median age:54.0, range:44-66y.o.) were included in this study. A non-contrast Triple-Inversion-Recovery Arterial-Spin-Labeling (TIR-ASL) technique was used to quantify the IHPVBV in one and two cardiac cycles. Liver (LV) and spleen volume (SV) were measured by manual segmentation from anatomical MR images as morphological markers of PH. All images were acquired in a 1.5T Philips Achieva MR scanner. PH patients had larger SV (P=0.02) and lower liver-to-spleen ratio (P=0.02) compared with healthy volunteers. The median IHPVBV in healthy volunteers was 13.5cm(3) and 26.5cm(3) for one and two cardiac cycles respectively, whereas in PH patients a median volume of 3.1cm(3) and 9.0cm(3) was observed. When correcting by LV, the IHPVBV was significantly higher in healthy volunteers than PH patients for one and two cardiac cycles. The combination of morphological information (liver-to-spleen ratio) and functional information (IHPVBV/LV) can accurately identify the PH patients with a sensitivity of 90% and specificity of 100%. Results show that the portal vein blood volume that flows into the intrahepatic volume in one and two cardiac cycles is significantly lower in PH patients than in healthy volunteers and can be quantified with non-contrast MRI techniques. Copyright © 2015. Published by Elsevier Inc.Magnetic Resonance Imaging 06/2015; DOI:10.1016/j.mri.2015.06.016 · 2.02 Impact Factor
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ABSTRACT: To study the liver and spleen volume variations in hepatic fibrosis patients at different histopathological stages. Multidetector computed tomography (MDCT) scan was performed in 85 hepatic fibrosis patients. Liver volume (LV) and spleen volume (SV) were measured. Fifteen healthy individuals served as a control group (S0). The patients were divided into stage 1 (S1) group (n = 34), stage 2 (S2) group (n = 25), stage 3 (S3) group (n = 16), and stage 4 (S4) group (n = 10) according to their histopathological stage of liver fibrosis. The LV and standard LV(SLV)had a tendency to increase with the severity of fibrosis, but no statistical difference was observed in the 5 groups (LV: F = 0.245, P = 0.912; SLV: F = 1.902, P = 0.116). The SV was gradually increased with the severity of fibrosis, and a statistically significant difference in SV was observed among the 5 groups (P < 0.01). The LV/SV ratio and SLV/SV ratio were gradually decreased with the aggravation of hepatic fibrosis, and statistically significant differences in both LV/SV and SLV/SV were found among the 5 groups (P < 0.01). The absence of obvious LV reduction in patients with chronic liver disease may be a morphological index of patients without liver cirrhosis. The SV is related to the severity of fibrosis, and the spleen of patients with advanced fibrosis is enlarged evidently. The LV/SV ratio and SLV/SV ratio are of a significant clinical value in the diagnosis of advanced liver fibrosis.World Journal of Gastroenterology 07/2009; 15(26):3298-302. · 2.43 Impact Factor
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ABSTRACT: The diagnostic criteria for primary biliary cirrhosis (PBC) in Japan were revised in 2004. The prevalence and prognosis of PBC using the revised criteria have not been reported. This study investigated the prevalence and prognosis of "newly-diagnosed" symptomatic-PBC (ns-PBC), which was defined as asymptomatic PBC (a-PBC) in Japan until 2004. The clinical features and the prognosis of 207 patients with PBC were retrospectively investigated according to clinical stage. The prevalence of ns-PBC was 3.4% and 9.7%, at the time of diagnosis and final evaluation, respectively. The prognosis of ns-PBC was poorer than a-PBC. A total of 7.2% of the patients with a-PBC progressed to ns-PBC during the observation period. These patients had a poorer prognosis than patients who remained asymptomatic. Approximately 10% of the PBC patients presented with signs of portal hypertension as an initial symptom. The signs of portal hypertension should therefore be carefully investigated in patients with PBC at the time of diagnosis and during the observation.Internal Medicine 01/2010; 49(12):1073-8. DOI:10.2169/internalmedicine.49.3169 · 0.97 Impact Factor