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Computed tomography–based evaluation of segmental variation of liver density and its implications

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) has become a major health concern. Focal fat deposition frequently seems to involve segment IV b. This indicates a consistent pattern of fat deposition in the liver. The present study evaluates the pattern of fat distribution in the liver using computed tomogram (CT) attenuation index.

Methods

Two radiologists evaluated 517 non-contrast CT scan images of the abdomen and pelvis. Two 40-mm2 regions of interest (ROIs) were selected from each segment. The hepatic segmental densities (HSDs) were obtained by calculating the mean densities of areas of corresponding liver segments. The mean hepatic attenuation (MHA) was quantified by obtaining the mean segmental densities. Densities were compared between the segments and with the MHA.

Results

The mean age (SD) of the patients was 55.5 year (15.6), and 276 (53.4%) were males. The overall mean hepatic density was 53.05 (95% CI, 52.95–53.15) Hounsfield units (HU). The lowest mean HSD was observed in segment IV b and the highest mean HSD was observed in segment V. Segments I, IV a and IV b showed significantly lower mean HSDs and segments V, VI and VIII showed significantly higher mean HSDs compared with the overall mean MHA/mean hepatic density (MHD), whereas mean HSDs of segments II, III and VII were not significantly different from the overall mean MHA/MHD.

Conclusion

Segment IV b seems to be the most vulnerable site for fat deposition; focal lesions here should be carefully evaluated. Segments II, III and VII seem to closely represent MHD.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    Rohan Chaminda Siriwardana & Thenuka Sivasundaram

  2. Department of Radiology, Central Hospital, Colombo, Sri Lanka

    Lakmali Paranaheva

  3. ICT Center, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    Dileepa Senajith Ediriweera

Authors
  1. Rohan Chaminda Siriwardana
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  2. Thenuka Sivasundaram
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  3. Lakmali Paranaheva
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  4. Dileepa Senajith Ediriweera
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Contributions

Siriwardana Rohan Chaminda designed, conducted and did the manuscript writing.

Sivasundaram Thenuka conducted CT reporting, analysis and manuscript writing.

Paranaheva Lakmali conducted CT reporting and planning the study.

Ediriweera Deleepa Senajith conducted the data analysis and manuscript writing.

Corresponding author

Correspondence to Rohan Chaminda Siriwardana.

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Conflict of interest

RCS, TS, LP, and DSE declare that they have no conflicts of interest.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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This paper was presented as an oral presentation in Joint International congress ILTS, ELITA and LICAGE in Prague 2017.

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Siriwardana, R.C., Sivasundaram, T., Paranaheva, L. et al. Computed tomography–based evaluation of segmental variation of liver density and its implications. Indian J Gastroenterol 39, 60–65 (2020). https://doi.org/10.1007/s12664-019-01008-8

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  • DOI: https://doi.org/10.1007/s12664-019-01008-8

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