An improved model based on quantitative features of right liver lobe, maximum varices, and portal vein system measured on magnetic resonance imaging to predict oesophagogastric variceal haemorrhage secondary to hepatitis B-related cirrhosis.

Autor:	Tan BG; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.; Department of Radiology, Panzhihua Central Hospital, Panzhihua, China., Tang Z; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Ou J; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Zhou HY; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Li R; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Chen TW; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China., Zhang XM; Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Li HJ; Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
Jazyk:	angličtina
Zdroj:	Quantitative imaging in medicine and surgery [Quant Imaging Med Surg] 2023 Dec 01; Vol. 13 (12), pp. 7741-7752. Date of Electronic Publication: 2023 Oct 20.
DOI:	10.21037/qims-23-353
Abstrakt:	Background: In patients with hepatitis B-related cirrhosis, it is important to predict those at high-risk of oesophagogastric variceal haemorrhage (OVH) to decide upon prophylactic treatment. Our published model developed with right liver lobe volume and diameters of portal vein system did not incorporate maximum variceal size as a factor. This study thus aimed to develop an improved model based on right liver lobe volume, diameters of maximum oesophagogastric varices (OV) and portal vein system obtained at magnetic resonance imaging (MRI) to predict OVH. Methods: Two hundred and thirty consecutive individuals with hepatitis B-related cirrhosis undergoing abdominal enhanced MRI were randomly grouped into training (n=160) and validation sets (n=70). OVH was confirmed in 51 and 23 participants in the training and validation sets during 2-year follow-up period, respectively. Spleen, total liver, right lobe, caudate lobe, left lateral lobe, and left medial lobe volumes, together with diameters of maximum OV and portal venous system were measured on MRI. In the training set, univariate analyses and binary logistic regression analyses were conducted to determine independent predictors. The performance of the model for predicting OVH constructed based on independent predictors from the training set was evaluated with receiver operating characteristic (ROC) analysis and validated in the validation set. Results: The model for predicting OVH was established based on right liver lobe volume and diameters of the maximum OV, left gastric vein, and portal vein [odds ratio (OR) =0.991, 2.462, 1.434, and 1.582, respectively; all P values <0.05]. The logistic regression model equation [-0.009 × right liver lobe volume + 0.901 × maximum OV diameter (MOVD) + 0.361 × left gastric vein diameter (LGVD) + 0.459 × portal vein diameter (PVD) - 7.842] with a cutoff value of -0.656 for predicting OVH obtained excellent performance with an area under ROC curve (AUC) of 0.924 [95% confidence interval (CI): 0.878-0.971]. The Delong test showed negative statistical difference in the model performance between the training and validation sets, with a P value >0.99. Conclusions: The model could help well screen those patients at high risk of OVH for timely intervention and avoiding the fatal complications. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-353/coif). The authors have no conflicts of interest to declare. (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)
Databáze:	MEDLINE
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