Characterization of Liver in Correlation with Liver Function Results using Computed Tomography

Abstract

The aims of this study were to evaluate liver measurements (linear, volume) and texture on computed tomography scan, to test their reflection in interpretation of the pattern of liver enzymes abnormality and to assess the ability of laboratory tests and liver imaging tests to detect hepatic diagnosis. Prospective study of 100 patients (41 males & 59 females) with ages ranged between 25-85 years was conducted at Royal diagnostic center during the period extended from June 2014 to July 2017. Total bilirubin, direct bilirubin, Alkaline Phosphatase (ALP), Aspartate Transaminase (AST), Alanine Transaminase (ALT), albumin, globulin, total protein and prothrombin time (PT) were evaluated and clearly correlated with computed tomography imaging results and with liver measurements. The linear hepatic measurements were evaluated including: mid hepatic point cranio caudal (MHP CC), maximum cranio caudal (Max CC), maximum transverse dimension (Max LL) and mid hepatic point anteroposterior (MHP AP) dimension. Hepatic volume measurements were performed depended on linear hepatic measurements: (MHP AP * Max LL * Max CC * 0.31) and the texture was evaluated for both right and left hepatic lobes and was measured in (Hounsfield). Cholangiocarcinoma was correlated significantly with AST level at p=0.038. Total bilirubin, direct bilirubin and ALP was correlated significantly with right lobe hepatocellular carcinoma (HCC) at p=0.004, 0.000 and 0.004 and with left lobe HCC at p=0.000, 0.025 and 0.042 respectively. Liver metastases decreased albumin level and was correlated significantly at p=0.030 and with total protein at p=0.025, while the PT was increased significantly with the presence of liver metastases at p=0.007 and cirrhosis at p=0.030. In the presence of Klatskin tumor the increasing of globulin was correlated significantly at p=0.003 and with total protein at p=0.001. VI Results showed that there were no significant relation between the presence of focal nodular hyperplasia, fatty liver disease, abscess and simple cyst with the total bilirubin, direct bilirubin, ALP, AST, ALT, albumin, globulin, total protein and PT. The results showed that there was no significant relation between the changing in hepatic measurements done by CT and the biochemical markers values and showed no significant relationship between the liver volume and the liver function test results except with the serum albumin at p=0.030. The evaluation of the liver density by measuring the CT Hounsfield was obtained showing only significant relation with globulin results at p=0.047 and total protein at p=0.017.