[原著］CT diagnosis of liver cirrhosis : CT analysis of 100 cases
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概要
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The CT images of 100 patients with liver cirrhosis, confirmed by surgery, pathology and clinical examination, were reviewed. Fifty individuals with normal hepatic images on CT were used as a control group. Alteration in lobar size in cirrhotic liver was analyzed by means of the measurement of lobar diameters and the calculation of their ratios. The results were compared with those of the control group. As the subject for measurement, the level of bifurcation of the main portal vein was chosen. On the CT slice, the anteroposterior (R1) and transverse (R2) diameters of the right lobe, anteroposterior diameter of the left lobe (L) , and transverse diameters of the caudate lobe (C) were measured and their ratios (Rl/L, R2/C) were calculated in both the cirrhosis and control groups. The control group showed $2.55 \pm 0.30$ in the R2/C ratio and $1.35 \pm 0.15$ in the R1/L ratio. Compared with the control group, the abnormal ratios of R1/L, and R2/C in cirrhotic liver were observed: 30 patients with a reduced ratio of R2/C (R2/C<1.96), 33 patients with an increased ratio of R2/C (R2/03.14), 35 patients with a reduced ratio of R1/L (R1/L<1.04), and 54 patients with an increased ratio of Rl/L (Rl/L>1.65). Using the abnormal ratio of R2/C to achieve a positive test for cirrhosis, a sensitivity of 63%, a specificity of 96%, and an accuracy of 74% were obtained. Using the abnormal ratio of R1/L to take a positive test for cirrhosis, a sensitivity of 78%, a specificity of 96% and an accuracy of 84% were obtained, and using the abnormal ratio of R2/C and R1/L to take a positive test for cirrhosis, a sensitivity of 90%, a specificity of 74% and an accuracy of 86% were obtained. Ten percent of cirrhotic cases showed a negative in positive test for cirrhosis. Those were some exceptional cases who presented shrinkage of the whole liver, revealing almost normal R1/L, and R2/C ratios and some cases who were revealed extreme enlargement of the lateral segment of the left lobe, extending across the midline to the left lateral wall of the upper abdomen. The results suggest that abnormal lobar diameter ratios, even reduced or increased R2/C and R1/L ratios, could be a significant piece of evidence in CT diagnosis for most cirrhotic cases.
- 琉球医学会の論文
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