Computerized liver imaging: relationship with quantitatively estimated histological parameters in liver cirrhosis

In liver cirrhosis, increased splenic uptake of radiocolloid, causing the liver-to-spleen (L/S) ratio to decrease, is a characteristic finding, especially during advanced illness. Histologically, advanced liver cirrhosis shows progressive replacement of hepatic parenchyma by fibrous tracts, making it possible to quantify both image and histological parameters. On this basis, the authors performed this study in 39 alcoholic cirrhotic patients in order to determine the relationship between the L/S ratio and right-to-left hepatic lobe ratio (RL/LL) and the degree of fibrosis, fat droplet area, total fat amount, and hepatocyte area. The authors tested if it is possible to predict the degree of fibrosis on the basis of image features or on a combination of image and biochemical parameters, using multiple correlation studies. The degree of fibrosis correlates with the L/S ratio (r = -0.48). The degree of correlation improved using prothrombin, gamma globulin and L/S ratio (r = 0.656), but not enough to allow an accurate estimation of the degree of fibrosis on the basis of a combination of imaging and biochemical data. Neither RL/LL nor L/S ratios significantly correlated with fatty infiltration, fat droplet area, or hepatocyte enlargement. Thus, liver imaging is not useful in quantifying the main histological changes observed in alcoholic liver cirrhosis.