title: Computed tomography findings in liver fibrosis and cirrhosis.
abstract: BACKGROUND
  Computed tomography (CT) is inferior to the fibroscan and laboratory testing in the noninvasive diagnosis of liver fibrosis. On the other hand, CT is a frequently used diagnostic tool in modern medicine. The auxiliary finding of clinically occult liver fibrosis in CT scans could result in an earlier diagnosis. The aim of this study was to analyse quantifiable direct signs of liver remodelling in CT scans to depict liver fibrosis in a precirrhotic stage.
  
  
  METHODS
  Retrospective review of 148 abdominal CT scans (80 liver cirrhosis, 35 precirrhotic fibrosis and 33 control patients). Fibrosis and cirrhosis were histologically proven. The diameters of the three main hepatic veins were measured 1-2 cm before their aperture into the inferior caval vein. The width of the caudate and the right hepatic lobe were divided, and measured horizontally at the level of the first bifurcation of the right portal vein in axial planes (caudate-right-lobe ratio). A combination of both (sum of liver vein diameters divided by the caudate-right lobe ratio) was defined as the ld/crl ratio. These metrics were analysed for the detection of liver fibrosis and cirrhosis.
  
  
  RESULTS
  An ld/crl-r <24 showed a sensitivity of 83% and a specificity of 76% for precirrhotic liver fibrosis. Liver cirrhosis could be detected with a sensitivity of 88% and a specificity of 82% if ld/crl-r <20.
  
  
  CONCLUSIONS
  An ld/crl-r <24 justifies laboratory testing and a fibroscan. This could bring forward the diagnosis and patients would profit from early treatment in a potentially reversible stage of disease.
authors.affiliation: Department of Diagnostic Radiology University Hospital of Bern, Inselspital, SWITZERLAND; adrian.huber@me.com.
authors.forename: A
authors.initials: A
authors.lastname: Huber
authors.forename: L
authors.initials: L
authors.lastname: Ebner
authors.forename: M
authors.initials: M
authors.lastname: Montani
authors.forename: N
authors.initials: N
authors.lastname: Semmo
authors.forename: K
authors.initials: K
authors.lastname: Roy Choudhury
authors.forename: J
authors.initials: J
authors.lastname: Heverhagen
authors.forename: A
authors.initials: A
authors.lastname: Christe
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed