Diagnosis of cirrhosis based on regional changes in hepatic morphology: a radiological and pathological analysis

Abstract

Transverse images of cirrhotic livers revealed specific morphological changes. The right lobe exhibited relatively greater shrinkage, while the caudate lobe underwent relative enlargement. Sonograms or CT scans of 25 proved cirrhotic livers, 25 normal livers, and 15 livers with diffuse disease other than cirrhosis were analyzed using a number of measurements and ratios to evaluate and quantify the frequency and possible diagnostic value of these alterations. Using the ratio of transverse caudate lobe width to transverse right lobe width, cirrhotic livers could be separated from noncirrhotic liver (both normal and abnormal) with a sensitivity of 84%, a specificity of 100%, and an accuracy of 94%. Another ratio revealed relative widening of the porta hepatis in 84% of cirrhotic livers, but this was not specific for cirrhosis. Pathological analysis of 11 cirrhotic cadaver livers revealed greater fibrosis in the right lobe than in the caudate lobe.