Objective To explore the feasibility and clinical significance of assessing liver function damage in patients with post-hepatitis cirrhosis using spectral CT by measuring the iodine density difference and CT value difference between the portal vein and hepatic vein. Methods A study was conducted involving 65 patients with post-hepatitis cirrhosis (30 with Child-Pugh grade A, 28 with grade B, and 7 with grade C) and 82 healthy controls. All underwent dual-phase enhanced spectral CT scans of the upper abdomen. Post-processing with IntelliSpace Portal software yielded iodine density (ID), 45 keV virtual monoenergetic (VMI), and conventional CT (HU) images. The mean iodine densities of the portal vein (IDP) and hepatic vein (IDV) were measured, and the difference in ID (IDd−value), VMI (VMId−value), and HU (HUd−value) between the portal vein and hepatic vein was calculated. These values were compared between the control group and different Child-Pugh grades of cirrhosis, as well as between the compensated cirrhosis group (Child-Pugh grade A) and the decompensated cirrhosis group (grade B/C). The ability to diagnose decompensated cirrhosis was evaluated by plotting ROC curves. Results The IDd−value, VMId−value, and HU d−value were significantly higher in the cirrhosis group compared to the control group and were also higher in the grade B/C group compared to the grade A group (all p<0.05). Among all patients with cirrhosis, the AUROC values for diagnosing grade B/C using IDd−value, VMId−value, HUd−value, NIDd−value, NVMI d−value, and NHUd−value were 0.774, 0.798, 0.736, 0.775, 0.774, and 0.757, respectively (all p < 0.05). Conclusions The iodine density difference (IDd−value) and CT value difference (VMId−value and HU d−value) between the portal vein and hepatic vein, as measured by spectral CT, demonstrate a significant positive correlation with the Child-Pugh classification of liver function in cirrhotic patients. These quantitative parameters provide a simple and non-invasive approach for assessing liver function in cirrhotic patients. Clinical trial number Not applicable.

Non-invasive assessment of liver function in cirrhosis using iodine density difference between the portal vein and hepatic vein on spectral CT: correlation with Child-Pugh grades

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2025年7月1日

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Lu Yu,
Zhengping Song,
Zhoulei Li,
Wen Lv,
Fei Yang,
Xuehua Li,
Canhui Sun

摘要

Objective

To explore the feasibility and clinical significance of assessing liver function damage in patients with post-hepatitis cirrhosis using spectral CT by measuring the iodine density difference and CT value difference between the portal vein and hepatic vein.

Methods

A study was conducted involving 65 patients with post-hepatitis cirrhosis (30 with Child-Pugh grade A, 28 with grade B, and 7 with grade C) and 82 healthy controls. All underwent dual-phase enhanced spectral CT scans of the upper abdomen. Post-processing with IntelliSpace Portal software yielded iodine density (ID), 45 keV virtual monoenergetic (VMI), and conventional CT (HU) images. The mean iodine densities of the portal vein (ID_P) and hepatic vein (ID_V) were measured, and the difference in ID (ID_d−value), VMI (VMI_d−value), and HU (HU_d−value) between the portal vein and hepatic vein was calculated. These values were compared between the control group and different Child-Pugh grades of cirrhosis, as well as between the compensated cirrhosis group (Child-Pugh grade A) and the decompensated cirrhosis group (grade B/C). The ability to diagnose decompensated cirrhosis was evaluated by plotting ROC curves.

Results

The ID_d−value, VMI_d−value, and HU _d−value were significantly higher in the cirrhosis group compared to the control group and were also higher in the grade B/C group compared to the grade A group (all p<0.05). Among all patients with cirrhosis, the AUROC values for diagnosing grade B/C using ID_d−value, VMI_d−value, HU_d−value, NID_d−value, NVMI _d−value, and NHU_d−value were 0.774, 0.798, 0.736, 0.775, 0.774, and 0.757, respectively (all p < 0.05).

Conclusions

The iodine density difference (ID_d−value) and CT value difference (VMI_d−value and HU _d−value) between the portal vein and hepatic vein, as measured by spectral CT, demonstrate a significant positive correlation with the Child-Pugh classification of liver function in cirrhotic patients. These quantitative parameters provide a simple and non-invasive approach for assessing liver function in cirrhotic patients.

Clinical trial number

Not applicable.