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Evaluation of splenic perfusion and spleen size using dynamic computed tomography: Usefulness in assessing degree of liver fibrosis
Author(s) -
Suzuki Takeshi,
Yamada Akira,
Komatsu Daisuke,
Kurozumi Masahiro,
Fujinaga Yasunari,
Ueda Kazuhiko,
Miyagawa Shinichi,
Kadoya Masumi
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12900
Subject(s) - spleen , perfusion , medicine , receiver operating characteristic , viral hepatitis , fibrosis , nuclear medicine , pathology , hepatic fibrosis , perfusion scanning , gastroenterology , radiology
Aim To enhance the usefulness of splenic perfusion evaluated by means of dynamic computed tomography (CT) and spleen size in assessing the degree of liver fibrosis. Methods We retrospectively studied 133 patients who had undergone dynamic CT before hepatectomy. Fibrosis was histologically established in all. First we calculated splenic perfusion parameters K 1 (inflow rate constant), 1/k 2 (mean transit time; MTT), and K 1 /k 2 (distribution volume; V d ), using compartment model analysis. Then we compared the stage of fibrosis with splenic perfusion and spleen size (long axis, R), using the Kruskal–Wallis test and multiple comparisons. After that, we assessed the diagnostic accuracy of the combination of splenic perfusion, spleen size, age, gender, and the presence or absence of hepatitis B and hepatitis C viral infection in detecting liver fibrosis, using stepwise regression and receiver operating characteristic analysis. Results Significant differences ( P < 0.05) in MTT were observed in comparisons between fibrosis stages F0 and F4, between F1 and F4, and between F2 and F4. Significant differences ( P < 0.05) in R were observed in comparisons between F0 and F4, and between F1 and F4. Considering the presence or absence of hepatitis B and C viral infection along with MTT and R, the areas under the receiver operating characteristic curves were 0.89 for ≥F1, 0.83 for ≥F2, 0.82 for ≥F3, and 0.82 for F4. Conclusion Splenic MTT and spleen size are helpful in assessing liver fibrosis.