Morphometric Changes in Liver Cirrhosis: Aetiological Differences Correlated with Progression

Objective: To evaluate the morphometric changes in liver cirrhosis using multidetector CT volumetry and to analyse the differences in morphometric changes among different aetiologies and stages of cirrhosis.

Methods: Each portal segment with the respective proportion relative to total liver volume was measured in 54 patients without cirrhosis as a control (male/female, 29/25; 62.4 ± 7.6 years) and 250 patients with cirrhosis (male/female, 172/78; 64.6 ± 9.2 years) related to hepatitis virus infection (n = 96), alcoholism (n = 88) and non-alcoholic steatohepatitis (NASH) (n = 66). 149 patients were classified as patients with Child-Pugh Class A, 57 patients as patients with Class B and 44 patients as patients with Class C. The Kruskal-Wallis test was used for statistical analysis (p < 0.05).

Results: Cirrhosis associated with all aetiologies commonly showed atrophy of the medial and anterior segments and right lobe and hypertrophy of the lateral segment and caudate lobe compared with the control (p < 0.05). In Child-Pugh Class A, hypertrophy of the caudate lobe progressed more in alcoholism and NASH than in virus-related aetiologies (p < 0.001). Hypertrophy of the lateral segment and atrophy of the medial and anterior segments and right lobe progressed less in NASH than in cases with virus related and alcoholic cirrhosis (p < 0.001). In patients with Class B, these differences were less prominent than in those with Class A (p < 0.001). In Class C, no significant differences were noted in any segment, regardless of aetiology (p > 0.05).

Conclusion: Morphometric changes of cirrhosis display different patterns according to aetiology. Differences between aetiologies would decrease with progression of cirrhosis.

Advances In Knowledge: Morphometric changes of cirrhosis display different patterns according to aetiology. Differences between aetiologies would decrease with progression of cirrhosis.