title: An elevated arterial enhancement fraction is associated with clinical and imaging indices of liver fibrosis and cirrhosis.
abstract: OBJECTIVE
  The objective of this study was to determine whether arterial enhancement fraction (AEF) is associated with the degree of liver fibrosis and cirrhosis in patients with chronic liver disease.
  
  
  METHODS
  Sixty-five patients (mean age, 55.8 years; 19 female patients) underwent triple-phase computed tomography scanning. Mean AEF was determined for the left and right hepatic lobe of the liver using a prototypical software module and compared between groups of different liver fibrosis grade.
  
  
  RESULTS
  Mean AEF was higher in patients with liver disease compared with those without liver disease. Mean AEF differed significantly between patients with normal liver or mild fibrosis (category 1), moderate to severe fibrosis (category 2), and cirrhosis (category 3). Receiver operating characteristic curve analysis determined an area under the curve of 0.79/0.78, with an optimal cutoff for mean AEF of 9.2/16.8, for differentiating between category 2 or higher/category 3 disease.
  
  
  CONCLUSIONS
  The mean hepatic AEF can provide an accurate, fast, noninvasive assessment of the degree of fibrosis in chronic liver disease.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
authors.forename: David
authors.initials: D
authors.lastname: Bonekamp
authors.forename: Susanne
authors.initials: S
authors.lastname: Bonekamp
authors.forename: Bernhard
authors.initials: B
authors.lastname: Geiger
authors.forename: Ihab R
authors.initials: IR
authors.lastname: Kamel
mesh_terms: D019540:Area Under Curve; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis; D006801:Humans; D007472:Iohexol; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D007472:Iohexol