This study hypothesized that the liver vein to cava attenuation (LVCA) on portal venous abdominal CT scans is a helpful add-on to liver volumetry and the caudate-right lobe ratio (crl-r) to detect clinically significant liver fibrosis.

Fifty consecutive patients with portal venous phase abdominal CT scans and gradient-echo based MR elastography within 3 months without portal vein thrombosis or prior liver surgery were included. One patient was excluded because of insufficient MR elastography quality. Thirty-six patients had a liver stiffness ≤3.5kPa, while twelve patients had a stiffness >3.5kPa, consistent with clinically significant liver fibrosis (corresponding to a fibrosis stage ≥f2). Liver segmental volume ratio (LSVR), defined as Couinaud segments I-III to segments IV to VIII, as well as LVCA (1-3: liver...

In accordance with earlier publications, LSVR correlated well with MR elastography measurements (r=0.63, p<0.001). However, LSVAR showed an even better correlation (r=0.74, p<0.001). Caudate-right lobe ratio was less useful (r=0.26, p=0.214), while LIMA-FS was just slightly inferior than volumetry (r=0.55, p<0.001).

LVCA is a helpful add-on to volumetry on portal venous abdominal CT scans. LIMA-FS, a combination of LVCA and crl-r, allows a just slightly inferior prediction of clinically significant liver fibrosis than volumetry without time-consuming image post-processing.

Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland Hepatology, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland

Pickhardt, P. J., Malecki, K., Hunt, O. F., Beaumont, C., Kloke, J., Ziemlewicz, T. J., & Lubner, M. G. (2017). Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis. European radiology, 27(7), 3060-3068. Hunt, O. F., Lubner, M. G., Ziemlewicz, T. J., del Rio, A. M., & Pickhardt, P. J. (2016). The Liver Segmental Volume Ratio (LSVR) for Non-invasive Detection of Cirrhosis: Comparison with established linear and volumetric measures. Journal of computer assisted tomography, 40(3), 478. Obmann, V. C., Mertineit, N., Berzigotti, A., Marx, C.,...