Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 7, 2007; 13(29): 3956-3961
Published online Aug 7, 2007. doi: 10.3748/wjg.v13.i29.3956
Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT
Rong Tu, Li-Ping Xia, An-Le Yu, Ling Wu
Rong Tu, An-Le Yu, Department of Radiology of Affiliated Hospital of Hainan Medical College, Cancer Research Center of Hainan Medical College, Haikou 571101, Hainan Province, China
Li-Ping Xia, Department of Surgery of Affiliated Hospital of Hainan Medical College, Haikou 571101, Hainan Province, China
Ling Wu, Department of Statistics of Hainan Medical College, Haikou 571101, Hainan Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Natural Science Foundation of Hainan Province, No. 30527
Correspondence to: Rong Tu, MD, Department of Radiology of Affiliated Hospital of Hainan Medical College, Longhua Street 33, Haikou 570102, Hainan Province, China. turong37472@126.com
Telephone: +86-898-66893280 Fax: +86-898-66893761
Received: January 31, 2007
Revised: February 3, 2007
Accepted: February 14, 2007
Published online: August 7, 2007
Abstract

AIM: To explore a method for quantitative assessment of hepatic functional reserve by combining computed tomography (CT) volumetry with CT grading of liver cirrhosis before liver resection in patients with hepatocellular carcinoma.

METHODS: CT images of 55 patients undergoing liver resection were studied prospectively. The degree of liver cirrhosis was referred as "CT grade" and the percentage of remnant liver volume (PRLV) [PRLV = predicted RLV/predicted total liver volume (PTLV) × 100%; PTLV (mL) = 121.75 + 16.49 × body mass (kg)] were calculated by adding slice by slice of CT liver images. The postoperative RLV, pathologic stages of liver fibrosis in non-tumor area and survival time in these cases were analyzed.

RESULTS: There was a significant difference in survival time between the group with PRLV ≤ 50% and the group with PRLV > 50% (χ2 = 4.988, P = 0.026), and between the group with CT grade 0/1 and the group with CT grade 2/3 (χ2 = 5.429, P = 0.026). With combination of the both parameters, an oblique line was identified according to the distribution of 32 survivors versus 23 deceased subjects. The mortality rate above the line was 7.1% (1/14), and that below the line was 53.7% (22/41), indicating a significant difference between the two rates (χ2 = 9.281, P = 0.002, P < 0.05).

CONCLUSION: PRLV and CT grades are significantly correlated with hepatic functional reserve. The predicted line using these two parameters is useful in candidates undergoing liver resection for judging hepatic functional reserve.

Keywords: Hepatic functional reserve; Liver cirrhosis; Computed tomography; Hepatocellular carcinoma