Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)

• Published in: Abdominal imaging 2021-05, Vol.46 (5), p.1912-1921
• Main Authors: Obmann, V. C., Marx, C., Hrycyk, J., Berzigotti, A., Ebner, L., Mertineit, N., Gräni, Ch, Heverhagen, J. T., Christe, A., Huber, A. T.
• Format: Article
• Language: English
• Subjects: Attenuation; Clinical significance; Computed tomography; Density; Fibrosis; Gastroenterology; Hepatobiliary; Hepatology; Imaging; Liver; Liver cirrhosis; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Radiology; Sensitivity; Stiffness
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-020-02834-7

Background The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR). Material and methods Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis. Results The LSVR and LSVAR allowed significant differentiation between patients with ( n  = 19) and without ( n  = 122) significantly elevated liver stiffness ( p