The value of multi-slice spiral computed tomography portography in assessing severity of liver cirrhosis and predicting episode risks of hepatic encephalopathy / 中华肝脏病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the clinical value of multi-slice spiral computed tomography portography (MSCTP) in assessing severity of liver cirrhosis and predicting episode risks of hepatic encephalopathy (HE).</p><p><b>METHODS</b>Eighty-six patients with liver cirrhosis who were hospitalized in the Department of Gastroenterology at the Affiliated Hospital of Yan'an University were included in the study.All patients underwent 64-slice MSCTP to grade the portal vein anatomy.The West Haven criteria were used for semi-quantitative assessment of each patient's mental state.The Child-Pugh grading system was used to assess the extent of cirrhosis.Comparison of measurement data between multiple groups was made by one-way ANOVA analysis, and comparison of such between two groups was made by the Mann-Whitney U test, Ranked data were compared with the rank-sum test, and count data were compared by the Chi-Square test.Correlation analysis was performed with Spearman's correlation test.</p><p><b>RESULTS</b>Comparison of the HE grade III group and the HE grade I group showed significant differences between the two in the diameters of left gastric vein, the splenic vein, the intrahepatic left portal vein and the intrahepatic right portal vein (P less than 0.05).Comparison of the Child-Pugh grade C group and the Child-Pugh grade A group showed significant differences between the two in diameters of the left gastric vein, the splenic vein, the intrahepatic left portal vein and the intrahepatic right portal vein (P less than 0.05).The diameters of the main portal vein were not significantly different between the ChildPugh grades and HE classifications (P more than 0.05).The results of MSCTP did show significant differences between different HE classifications in patients with liver cirrhosis and the rate of formation of portal vein thrombosis and fistulas of the hepatic artery-portal vein (P less than 0.05), .but no significant differences with the esophageal and gastric varices, varicose veins around the esophagus, and periumbilical varicose veins (P more than 0.05).HE classification was significantly correlated with formation of portal vein thrombosis and fistula of the hepatic artery-portal vein (r=0.687, P less than 0.05 and r=0.565, P less than 0.05, respectively).MSCTP grading (grade 1n=35, grade 2n=36, grade 3n=15) was not correlated with the Child-Pugh grade (grade An=36, grade Bn=32, grade Cn=18) (Z=-0.135, P more than 0.05).Incidence of HE was significantly different among the different MSCTP grades (grade 10%(0), grade 233.3% (12/36), grade 366.7% (10/15); x2=26.468, P less than 0.05).The MSCTP grade was significantly correlated with the episode risks of HE (r=0.552, P less than 0.05).</p><p><b>CONCLUSION</b>MSCTP may be valuable for assessing severity of liver cirrhosis and for predicting episode risks of HE; however, future studies with larger sample numbers is required for validation of our findings.</p>