Correlation between the severity of hepatitis B cirrhosis and CT volumetry-based hepatic segmental anatomic changes

Abstract

© 2014 Medical Association of Thailand. All rights reserved. Objective: To study the correlation between the changes of hepatic segmental volumes and the severity of hepatitis B cirrhosis, classified by Child-Pugh score.Material and Method: The study cohort comprised viral hepatitis B cirrhotic patients with different severity (Child-Pugh score grade A to C) and control subjects who underwent hepatic computed tomographic (CT) scan between February 2006 and May 2012. The volumes of total liver (TLV), right lobe (RV), left medial segment (LMV), left lateral segment (LLV), and caudate lobe (CV) were measured and compared between the control group and Child-Pugh A, B, and C groups.Results: Among 120 hepatitis B cirrhotic subjects, there were 85 males (70.8%) with the mean age of 59.2 years (range 36-86 years). Sixty-two subjects were Child-Pugh A, 39 were Child-Pugh B, and 19 were Child-Pugh C. Among 62 control subjects, there were 28 males (45.2%) with the mean age of 54.5 years (range 19-82 years). The TLV and RV were significantly decreased in Child-Pugh B and C subjects when compared with control subjects. LMV was significantly decreased in Child-Pugh A and continually decreased along with the severity of the disease. LLV was significantly increased in Child-Pugh A and B, but relative in Child-Pugh C subjects. CV was not significantly different in these four groups.Conclusion: Hepatitis B cirrhotic patients had progressive hepatic atrophy, initially by left medial segment, followed by right lobe and the whole liver. Hypertrophy of left lateral segment was evident in early cirrhosis but not significantly shown in severe cirrhosis. Hypertrophy of caudate lobe was not evident in any degrees of hepatitis B cirrhosis.