Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10184-10191
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10184
Platelet count combined with right liver volume and spleen volume measured by magnetic resonance imaging for identifying cirrhosis and esophageal varices
Xiao-Li Chen, Tian-Wu Chen, Xiao-Ming Zhang, Zhen-Lin Li, Nan-Lin Zeng, Ping Zhou, Hang Li, Jing Ren, Guo-Hui Xu, Jia-Ni Hu
Xiao-Li Chen, Tian-Wu Chen, Xiao-Ming Zhang, Nan-Lin Zeng, Hang Li, Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Xiao-Li Chen, Jing Ren, Guo-Hui Xu, Department of Radiology, Sichuan Cancer Hospital and Institute and The Second People’s Hospital of Sichuan Province, Chengdu 610041, Sichuan Province, China
Zhen-Lin Li, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Ping Zhou, Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Jia-Ni Hu, Department of Radiology, Wayne State University, Detroit, MI 48201, United States
Author contributions: Chen XL, Chen TW, Zhang XM, Li ZL and Li H designed the research; Chen XL, Li H, Zeng NL and Zhou P performed the research; Chen XL, Chen TW, Zhang XM, Li ZL, Ren J, Xu GH and Hu JN contributed new reagents/analytic tools; Li H, Chen XL and Chen TW analyzed the data; Chen XL, Chen TW and Li H wrote the paper; Chen XL, Zhang XM, Li ZL, Zeng NL, Zhou P, Li H, Ren J and Xu GH contributed equally to this work.
Supported by The National Natural Science Foundation of China, No. 81050033; the Key Projects of Sichuan Province Science and Technology Pillar Program, No. 2011SZ0237; the Science Foundation for Distinguished Young Scholars of Sichuan Province in China, No. 2010JQ0039; the Key Science and Technology Project of Chinese Ministry of Public Health, No. 2014114; and the Natural Science Key Project of North Sichuan Medical College, No. CBY12-A-ZD03.
Institutional review board statement: This study was reviewed and approved by the Committee for Ethical Review of Research involving Human Subjects of Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Informed consent statement: All study participants, or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article are reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tian-Wu Chen, MD, Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong 637000, Sichuan Province, China. chentw@aliyun.com
Telephone: +86-817-2262236 Fax: +86-817-2262236
Received: April 1, 2015
Peer-review started: April 2, 2015
First decision: June 2, 2015
Revised: July 7, 2015
Accepted: July 18, 2015
Article in press: July 18, 2015
Published online: September 21, 2015
Abstract

AIM: To determine whether the combination of platelet count (PLT) with spleen volume parameters and right liver volume (RV) measured by magnetic resonance imaging (MRI) could predict the Child-Pugh class of liver cirrhosis and esophageal varices (EV).

METHODS: Two hundred and five cirrhotic patients with hepatitis B and 40 healthy volunteers underwent abdominal triphasic-enhancement MRI and laboratory examination of PLT in 109/L. Cirrhotic patients underwent endoscopy for detecting EV. Spleen maximal width (W), thickness (T) and length (L) in mm together with spleen volume (SV) and RV in mm3 were measured by MRI, and spleen volume index (SI) in mm3 was obtained by W × T × L. SV/PLT, SI/PLT and RV × PLT/SV (RVPS) were calculated and statistically analyzed to assess cirrhosis and EV.

RESULTS: SV/PLT (r = 0.676) and SI/PLT (r = 0.707) increased, and PLT (r = -0.626) and RVPS (r = -0.802) decreased with the progress of Child-Pugh class (P < 0.001 for all). All parameters could determine the presence of cirrhosis, distinguish between each class of Child-Pugh class, and identify the presence of EV [the areas under the curve (AUCs) = 0.661-0.973]. Among parameters, RVPS could best determine presence and each class of cirrhosis with AUCs of 0.973 and 0.740-0.853, respectively; and SV/PLT could best identify EV with an AUC of 0.782.

CONCLUSION: The combination of PLT with SV and RV could predict Child-Pugh class of liver cirrhosis and identify the presence of esophageal varices.

Keywords: Cirrhosis, Spleen, Hepatic lobe, Magnetic resonance imaging, Platelet count

Core tip: This study determined whether and how the combination of platelet count (PLT) with spleen volume (SV) and right liver volume (RV) by MRI could predict the Child-Pugh class of liver cirrhosis and esophageal varices (EV). We confirmed that the ratio of SV/PLT increased with the progress of Child-Pugh class, PLT and RVPS (RV × PLT/SV) decreased with the progress of Child-Pugh class. As a new combined parameter, RVPS can be an optimized marker to identify the occurrence of cirrhosis and differentiate the Child-Pugh class. SV/PLT could be recommended for identifying the presence of EV.