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. 2019 Feb 18;9(1):2179.
doi: 10.1038/s41598-019-38669-6.

Quantitative Analysis of CT Images in Patients with Pyrrolizidine Alkaloid-Induced Sinusoidal Obstruction Syndrome

Chao Wang  1 , Xingwang Wu  2 , Wentao Xie  3 , Xiaofei Ren  1 , Weiping Zhang  1 , Jianming Xu  4
Affiliations

Quantitative Analysis of CT Images in Patients with Pyrrolizidine Alkaloid-Induced Sinusoidal Obstruction Syndrome

Chao Wang et al. Sci Rep. .

Abstract

This study evaluated hepatic lesion volumes on contrast-enhanced computed tomography (CT) images in patients with pyrrolizidine alkaloid-induced sinusoidal obstruction syndrome (PA-SOS) and the association of lesion volume with the clinical severity and prognosis of the disease. Twenty-five patients with PA-SOS were included in this study, and all patients were subjected to a complete CT imaging series. The imaging results were quantitatively analyzed by a threshold-based region growing algorithm. The liver volumes and hepatic lesion volumes of the patients were estimated. Based on clinical presentations, PA-SOS was classified into three categories: mild, moderate and severe. The associations of hepatic lesion volumes with liver function test parameters and the clinical severity and prognosis of the disease were analyzed. Based on estimations using the threshold-based region growing algorithm, hepatic lesion volumes in patients with mild PA-SOS were significantly lower than those in patients with moderate and severe PA-SOS (P < 0.05). The ratio of hepatic lesion volume to liver volume (Ratio) varied based on alanine aminotransferase (ALT), aspartate aminotransferase (AST) and serum total bilirubine levels; clinical severity; and disease prognosis, and the differences were statistically significant (P < 0.05). In conclusion, the threshold-based region growing algorithm can be employed to quantitatively analyze enhanced CT images of PA-SOS patients. And the ratio of hepatic lesion volume to liver volume in patients with PA-SOS is associated with a more serious clinical course and a poorer outcome.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart for patient selection.
Figure 2
Figure 2
(A) 49-year-old man was diagnosed with PA-SOS and underwent contrast-enhanced CT. CT images were denoised using the anisotropic diffusion method; (A) original and (B) denoised.
Figure 3
Figure 3
ROIs were extracted by the threshold-based region growing method (ROIliver, ROIlesion and ROIenhancement are represented by the green line, yellow line and red line, respectively): The volumes for (A) ROIliver and (B) ROIlesion were 2334821.84 mm3 (2.335 L) and 1650085.09 mm3 (1.650 L), respectively.
See this image and copyright information in PMC

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