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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2012, Vol. 6 Issue (4) : 421-427     DOI: 10.1007/s11684-012-0223-5
RESEARCH ARTICLE |
Assessment of liver volume variation to evaluate liver function
Cong Tong1, Xinsen Xu1, Chang Liu1(), Tianzheng Zhang2, Kai Qu1
1. Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an 710061, China; 2. Department of Surgery, Shaanxi Xianyang 215 Hospital, Xianyang 712000, China
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Abstract  

In order to assess the value of liver volumetry in cirrhosis and acute liver failure (ALF) patients, we explored the correlation between hepatic volume and severity of the hepatic diseases. The clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were collected. Computed tomography-derived liver volume (CTLV) and body surface area (BSA) of normal controls were calculated to get a regression formula for standard liver volume (SLV) and BSA. Then CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further comparison. It turned out that the mean liver volume of the control group was 1 058±337 cm3. SLV was correlated with BSA according to the regression formula. The hepatic volume of cirrhosis patients in Child A, B level was not reduced, but in Child C level it was significantly reduced with the lowest liver volume index (CTLV/SLV). Likewise, in the death group of ALF patients, the volume index was significantly lower than that of the survival group. Based on volumetric study, we proposed an ROC (receiver operating characteristic) analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor prognosis. In conclusion, the CTLV/SLV ratio, which reflects liver volume variations, correlates well with the liver function and progression of cirrhosis and ALF. It is also a very useful marker for predicting the prognosis of ALF.

Keywords liver volume variation      cirrhosis      acute liver failure (ALF)     
Corresponding Authors: Liu Chang,Email:liuchangdoctor@163.com   
Issue Date: 05 December 2012
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-012-0223-5     OR     http://academic.hep.com.cn/fmd/EN/Y2012/V6/I4/421
Fig.1  Volumetric analysis of the liver. (A) To outline the edge of the liver on each slice of the CT films with a cursorB) Reconstruction of the liver by adding the area of each slice from the most superior part to the most inferior part.
DiagnosisGenderAge (year)Height (cm)Weight (kg)
MaleFemale
Normal controls402052±13167.0±6.458.2±10.9
CirrhosisChild A7355±16168.8±6.963.9±8.7
Child B151149±13168.0±7.559.8±10.5
Child C9347±15167.0±4.659.0±11.8
ALFDeath group11536±11170.1±6.963.6±9.3
Survival group20343±15168.5±8.963.2±9.3
Tab.1  Baseline characteristics of the patients
Child-Turcotte-Pugh classificationNo. of patientsSLV (cm3)CTLV (cm3)Volume indexa
Child A101 231±1201 156±2580.94±0.18
Child B261 189±1401 054±4300.87±0.31
Child C121 174±129814±169 b0.71±0.20b
Tab.2  Correlation between cirrhotic liver volume index and liver function
Fig.2  Difference of the volume index between different cirrhosis Child classes.
GroupsPrognosisNo. of patientsSLV (cm3)CTLV (cm3)Volume indexa
ASurvival231 227±1271 164±1370.95±0.11
BDeath161 219±116981±1100.81±0.10 b
Tab.3  Correlation between ALF liver volume index and liver function
Fig.3  Difference of the volume index between different ALF prognosis.
Fig.4  ROC analysis of the ALF volume index.
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