Confluent hepatic fibrosis in liver cirrhosis: possible relation with middle hepatic venous drainage

Our aim was to retrospectively analyze the location of confluent hepatic fibrosis in relation to the portal and hepatic venous anatomy using multidetector computed tomography (CT) and to clarify the influence of the hepatic venous drainage on confluent fibrosis.

The study population consisted of 879 patients diagnosed with cirrhosis: 539 men and 340 women (65.9 ± 10.6 years) and 633 with Child-Pugh class A, 161 with class B, and 85 with class C. The cause of cirrhosis was hepatitis C (n = 528) and hepatitis B (n = 122) virus infection, alcoholism (n = 114), and others (n = 115). The confluent fibrosis was diagnosed using CT images according to previous reports and statistically analyzed (p < 0.05).

Thirty-five confluent fibrosis lesions in 30 patients (3.4 %) were identified. The predictive factors were alcoholic cirrhosis [odds ratio (OR), 7.25; p < 0.0001], Child-Pugh class C (OR, 6.95; p < 0.0001), and Child-Pugh class B (OR, 2.91; p < 0.0023). Confluent fibrosis was most frequently seen in the middle hepatic venous drainage area (n = 21) or at the boundary between the medial and anterior segments (n = 17), and each distribution of the location of confluent fibrosis was significantly unequal (p < 0.0001).

Confluent fibrosis was most commonly located in the middle hepatic venous drainage area.