Albumin and magnetic resonance imaging-liver volume to identify hepatitis B-related cirrhosis and esophageal varices

doi:10.3748/wjg.v21.i3.988

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World Journal of Gastroenterology

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World J Gastroenterol. Jan 21, 2015; 21(3): 988-996
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.988

Table 1 Interobserver variability of each liver lobe volume parameter between two observers’ measurements in cirrhotic patients with hepatitis B

Liver lobe volume parameters	Mean coefficient of variation (range)	≤ 10% (n)	> 10% (n)
RV	7.5% (2%-14%)	59	12
LMV	8.6% (3%-15%)	61	10
LLV	8.2% (3%-13%)	63	8
CV	6.0% (2%-11%)	69	2
RV/ALB	5.5% (1%-11%)	70	1
LMV/ALB	6.4% (1%-10%)	71	0
LLV/ALB	6.2% (2%-10%)	71	0
CV/ALB	4.0% (2%-9%)	71	0

RV: Right liver lobe volume; LMV: Left medial liver lobe volume; LLV: Left lateral liver lobe volume; CV: Caudate lobe volume; ALB: Albumin.

Table 2 Main clinical data of the healthy volunteers and patients with cirrhosis in different Child-Pugh classes

	No cirrhosis	Child-Pugh class of cirrhosis
	(n = 21)	Class A (n = 27)	Class B (n = 28)	Class C (n = 16)
Gender (M/F)	12/9	12/15	13/15	11/5
Age	56.23 ± 13.02	59.43 ± 12.93	54.57 ± 12.59	53.56 ± 16.13
Body weight (kg)	65.42 ± 5.34	60.53 ± 3.20	57.61 ± 2.05	55.33 ± 1.53
BMI (kg/m²)	23.15 ± 0.54	22.42 ± 0.45	21.25 ± 0.31	19.41 ± 0.24
RV (mm³)	806.45 ± 198.89¹	649.60 ± 123.46	586.98 ± 137.28³	470.58 ± 46.03⁴
LMV (mm³)	234.29 ± 70.341	193.23 ± 47.05²	161.27 ± 43.04	147.47 ± 83.75⁴
LLV (mm³)	215.51 ± 133.63	279.60 ± 95.33²	218.69 ± 35.47	208.49 ± 36.17⁴
CV (mm³)	20.28 ± 9.35¹	34.36 ± 10.46	29.15 ± 12.23	22.41 ± 10.94⁴
ALB (g/L)	45.27 ± 3.46	37.82 ± 4.07	33.24 ± 2.56	26.76 ± 3.23
RV/ALB	17.59 ± 4.31	16.98 ± 3.03	18.61 ± 4.12	20.45 ± 3.55⁴
LMV/ALB	5.52 ± 1.73	5.16 ± 1.39	5.15 ± 1.45	6.43 ± 3.81
LLV/ALB	5.14 ± 3.41¹	7.29 ± 2.95	7.08 ± 1.26³	9.19 ± 1.40⁴
CV/ALB	0.48 ± 0.24¹	0.87 ± 0.28	0.95 ± 0.43	0.96 ± 0.45

¹Different from Cirrhosis group, P < 0.05;

²Different from Class B, P < 0.05;

³Different from Class C, P < 0.05;

⁴Different from Class A, P < 0.05. BMI: Body mass index; RV: Right liver lobe volume; LMV: Left medial liver lobe volume; LLV: Left lateral liver lobe volume; CV: Caudate lobe volume; ALB: Albumin.

Table 3 Comparison of liver lobe volume parameters between patients with and without esophageal varices

Parameters	Esophageal varices
	No (n = 46)	Yes (n = 25)
RV (mm³)	687.85 ± 175.73¹	534.87 ± 85.86
LMV (mm³)	190.01 ± 63.70	167.18 ± 66.70
LLV (mm³)	544.26 ± 98.74	216.05 ± 39.04
CV (mm³)	27.52 ± 12.83	27.61 ± 8.54
RV/ALB	16.98 ± 3.36¹	21.26 ± 3.01
LMV/ALB	5.26 ± 1.68	5.96 ± 2.96
LLV/ALB	6.91 ± 2.77	7.78 ± 1.92
CV/ALB	0.78 ± 0.41¹	0.97 ± 0.31

¹Different from the patients with esophageal varices, P < 0.05. RV: Right liver lobe volume; LMV: Left medial liver lobe volume; LLV: Left lateral liver lobe volume; CV: Caudate lobe volume; ALB: Albumin.

Table 4 Volume parameters of each liver lobe in determining the presence and Child-Pugh class of liver cirrhosis, and predicting the presence of esophageal varices

Parameters	Cut-off	Differentiations	AUC	Sensitivity	Specificity
RV (mm³)	692.3	No cirrhosis vs cirrhosis	0.816	70.6%	75%
	508.9	Class A vs C	0.900	90.3%	84.5%
	522.2	Class B vs C	0.803	70.0%	88%
	579.45	No varices vs varices	0.780	71.4%	70.0%
LMV (mm³)	201.3	No cirrhosis vs cirrhosis	0.754	70.6%	77.0%
	181.1	Class A vs B	0.728	68.0%	71.0%
	155.4	Class A vs C	0.751	82.1%	75.0%
LLV (mm³)	233.2	Class A vs B	0.761	74.4%	73.1%
	224.9	Class A vs C	0.792	82.1%	75.0%
CV (mm³)	23.8	No cirrhosis vs cirrhosis	0.756	69.0%	65.0%
	25.1	Class A vs C	0.806	85.7%	69.0%
RV/ALB	19.9	Class A vs C	0.801	68.8%	79.6%
	20.46	No varices vs varices	0.890	80.0%	83.5%
LLV/ALB	0.9	No cirrhosis vs cirrhosis	0.763	70.6%	71.0%
	8.3	Class A vs C	0.752	68.8%	65.5%
	7.5	Class B vs C	0.900	93.8%	81.5%
CV/ALB	0.6	No cirrhosis vs cirrhosis	0.860	82.0%	83.0%
	0.825	No varices vs varices	0.673	64.0%	67.0%

RV: Right liver lobe volume; LMV: Left medial liver lobe volume; LLV: Left lateral liver lobe volume; CV: Caudate lobe volume; ALB: Albumin.

Table 5 Volume parameters of liver lobes for best identifying the presence and Child-Pugh class of liver cirrhosis, and predicting the presence of esophageal varices

Parameter	Cut-off	Differentiations	Sensitivity	Specificity
CV/ALB	0.6	No cirrhosis vs cirrhosis	82.0%	83.00%
RV (mm³)	508.9	Class A vs C	90.3%	84.5%
LLV/ALB	7.5	Class B vs C	93.8%	81.5%
LLV (mm³)	233.2	Class A vs B	74.4%	73.1%
RV/ALB (mm³)	20.46	No varices vs varices	80.0%	83.5%

RV: Right liver lobe volume; LMV: Left medial liver lobe volume; LLV: Left lateral liver lobe volume; CV: Caudate lobe volume; ALB: Albumin.

Citation: Li H, Chen TW, Li ZL, Zhang XM, Li CJ, Chen XL, Chen GW, Hu JN, Ye YQ. Albumin and magnetic resonance imaging-liver volume to identify hepatitis B-related cirrhosis and esophageal varices. World J Gastroenterol 2015; 21(3): 988-996
URL: https://www.wjgnet.com/1007-9327/full/v21/i3/988.htm
DOI: https://dx.doi.org/10.3748/wjg.v21.i3.988