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Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation

BACKGROUND: Liver cirrhosis-acute decompensation (LC-AD) has rapid short-term disease progression and difficult early risk stratification. The purpose is to develop and validate a model based on dual-energy CT quantification of extracellular liver volume (ECV(IC-liver)) for predicting the occurrence...

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Autores principales: Xu, Yuan, Li, Yufeng, Li, Shenglin, Xue, Shouxiao, Liu, Jianli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050608/
https://www.ncbi.nlm.nih.gov/pubmed/36977956
http://dx.doi.org/10.1186/s13244-023-01393-x
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author Xu, Yuan
Li, Yufeng
Li, Shenglin
Xue, Shouxiao
Liu, Jianli
author_facet Xu, Yuan
Li, Yufeng
Li, Shenglin
Xue, Shouxiao
Liu, Jianli
author_sort Xu, Yuan
collection PubMed
description BACKGROUND: Liver cirrhosis-acute decompensation (LC-AD) has rapid short-term disease progression and difficult early risk stratification. The purpose is to develop and validate a model based on dual-energy CT quantification of extracellular liver volume (ECV(IC-liver)) for predicting the occurrence of acute-on-chronic liver failure (ACLF) within 90 days in patients with hepatitis B (HBV) LC-AD. METHODS: The retrospective study included patients with HBV LC-AD who underwent dual-energy CT scans of the liver from January 2018 to March 2022 and were randomized to training group (215 patients) and validation group (92 patients). The primary outcome was the need for readmission within 90 days due to ACLF. Based on the training group data, independent risk factors for disease progression in clinical and dual-energy CT parameters were identified and modeled by logistic regression analysis. Based on the training and validation groups data, receiver operating characteristic (ROC) curves, calibration curves, and decision analysis curves (DCA) were used to verify the discrimination, calibration, and clinical validity of the nomogram. RESULTS: Chronic liver failure consortium-acute decompensation score (CLIF-C ADs) (p = 0.008) and ECV(IC-liver) (p < 0.001) were independent risk factors for ACLF within 90 days. The AUC of the model combined ECV(IC-liver) and CLIF-C ADs were 0.893 and 0.838 in the training and validation groups, respectively. The calibration curves show good agreement between predicted and actual risks. The DCA indicates that the model has good clinical application. CONCLUSION: The model combined ECV(IC-liver) and CLIF-C ADs can early predict the occurrence of ACLF within 90 days in HBV LC-AD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13244-023-01393-x.
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spelling pubmed-100506082023-03-30 Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation Xu, Yuan Li, Yufeng Li, Shenglin Xue, Shouxiao Liu, Jianli Insights Imaging Original Article BACKGROUND: Liver cirrhosis-acute decompensation (LC-AD) has rapid short-term disease progression and difficult early risk stratification. The purpose is to develop and validate a model based on dual-energy CT quantification of extracellular liver volume (ECV(IC-liver)) for predicting the occurrence of acute-on-chronic liver failure (ACLF) within 90 days in patients with hepatitis B (HBV) LC-AD. METHODS: The retrospective study included patients with HBV LC-AD who underwent dual-energy CT scans of the liver from January 2018 to March 2022 and were randomized to training group (215 patients) and validation group (92 patients). The primary outcome was the need for readmission within 90 days due to ACLF. Based on the training group data, independent risk factors for disease progression in clinical and dual-energy CT parameters were identified and modeled by logistic regression analysis. Based on the training and validation groups data, receiver operating characteristic (ROC) curves, calibration curves, and decision analysis curves (DCA) were used to verify the discrimination, calibration, and clinical validity of the nomogram. RESULTS: Chronic liver failure consortium-acute decompensation score (CLIF-C ADs) (p = 0.008) and ECV(IC-liver) (p < 0.001) were independent risk factors for ACLF within 90 days. The AUC of the model combined ECV(IC-liver) and CLIF-C ADs were 0.893 and 0.838 in the training and validation groups, respectively. The calibration curves show good agreement between predicted and actual risks. The DCA indicates that the model has good clinical application. CONCLUSION: The model combined ECV(IC-liver) and CLIF-C ADs can early predict the occurrence of ACLF within 90 days in HBV LC-AD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13244-023-01393-x. Springer Vienna 2023-03-29 /pmc/articles/PMC10050608/ /pubmed/36977956 http://dx.doi.org/10.1186/s13244-023-01393-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Xu, Yuan
Li, Yufeng
Li, Shenglin
Xue, Shouxiao
Liu, Jianli
Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title_full Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title_fullStr Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title_full_unstemmed Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title_short Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation
title_sort dual-energy ct quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis b liver cirrhosis-acute decompensation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050608/
https://www.ncbi.nlm.nih.gov/pubmed/36977956
http://dx.doi.org/10.1186/s13244-023-01393-x
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