Heterogeneity of hepatic parenchymal enhancement on computed tomography during arterial portography: quantitative analysis of correlation with severity of hepatic fibrosis

Background/Aims: In patients with chronic liver disease, heterogeneous enha ncement of liver parenchyma is often noted on computed tomography during ar terial portography (CTAP). We investigated the factors contributing to the heterogeneous enhancement and its relationship with postoperative histopath ological findings. Methodology: Eighty-seven patients who had undergone a r ight lobectomy for liver tumor after CTAP were evaluated. The heterogeneity of hepatic parenchymal enhancement on CTAP was assessed quantitatively usi ng standard deviation of mean CT numbers for five ROIs (S.D.) set in the ri ght hepatic lobe, and comparatively evaluated among three histological grou ps (liver cirrhosis (LC, n =41), chronic hepatitis (CH, n = 33), and normal liver (Normal, n = 13)). Severity of fibrosis and degree of splenomegaly ( Sp) were taken up as factors contributory to the heterogeneity, and were as sessed for correlation with the S.D. Results: The range (mean) of S.D. was LC, 3.07-17.64 (9.10); CH, 1.83-11.12 (6.77); and Normal, 2.06-8.89 (5.64) (Scheffe's F-test: LC vs CH, P < 0.0005; LC vs Normal, P < 0.0002). The hig her fibrosis group exhibited significantly greater S.D. values as compared with the lower fibrosis group (Scheffe's F-test: P < 0.00003). Coefficient of correlation between the S.D. and the Sp was 0.295 (P < 0.005). Conclusio n: There was a fair possibility of LC in patients with heterogeneous enhanc ement of liver parenchyma on CTAP. The severity of liver fibrosis and the d egree of splenomegaly were considered to be factors contributing to the het erogeneous enhancement. (C) 2001 Elsevier Science Ireland Ltd. All rights r eserved.