Abstract:

Objective

To analyze the clinical data of MSCT examination and Child-Pugh score of liver function in patients with clinically proven cirrhosis，to establish the evaluation model of liver function compensatory status based on MSCT liver volume measurement，and to verify its accuracy and reliability.

Methods

This study was a retrospective analysis. A total of 170 patients with liver cirrhosis who underwent MSCT examination in Beijing Daxing District People's Hospital from July 2020 to July 2023 were selected as the research objects. The patients were divided into a modeling set and a validation set according to a 3∶1 ratio. There were 144 cases in the modeling set and 26 cases in the validation set.According to the total score of Child-Pugh classification of liver function，the modeling set was divided into two groups： Child-Pugh A and B group and Child-Pugh C group. The differences in clinical data，CT parameters，CT volume and perfusion parameters between the two groups were compared in the modeling set. Binary Logistic regression was used to construct the prediction model，and ROC curve and Z test were used. The diagnostic performance of each model was compared.

Results

In the modeling set，the proportion of hepatic encephalopathy，ascites，TBIL and INR in Child-Pugh C group were higher than those in Child-Pugh A and B group，and ALB was lower than that in Child-Pugh A and B group，with statistically significant differences （P＜0.05）. In the modeling set，the MTT in Child-Pugh C group was longer than that in Child-Pugh A and B group，and HAF，A/V and caudate lobe volume were higher than those in Child-Pugh A and B group. BF，BV，PVP，HAP，total liver volume，right liver volume and left medial lobe volume were lower than those in Child-Pugh A and B group，and CAAT was shorter than that in Child-Pugh A and B group （P＜0.05）. According to multivariate Logistic regression model analysis，BF，BV，MTT，HAF，PVP，CAAT，HAP，A/V，total liver volume，right liver volume，left medial lobe volume and caudate lobe volume were all independent risk factors affecting liver function compensatory status in patients with cirrhosis （P＜0.05）. Hosmer-Lemeshow fit test showed that there were no statistically significant differences between the prediction model of liver volume parameters without MSCT and the prediction model with MSCT （P=0.889，0.388）. Z-test showed that the difference of area under ROC curve between the two prediction models was 0.037 （P＜0.05）. The ROC AUC of liver volume parameter prediction model with MSCT was 0.865 （95% CI： 0.814-0.936），and the prediction efficiency was good.The AUC of liver volume parameter prediction model with MSCT of the independent validation set was 0.749 （95% CI： 0.622-0.840）. The Hosmer-Lemeshow test of verification set showed that the model prediction was in good agreement with the actual value （P=0.084）.

Conclusion

MSCT liver volume measurement shows a good application prospect in evaluating liver function compensatory status in patients with cirrhosis. By combining the liver volume and perfusion parameters provided by MSCT，the liver function compensatory status of patients can be evaluated more accurately and provide strong support for clinical decision-making.

Key words: Liver cirrhosis, Tomography,spiral computer, Liver volume, Liver reserve