Karaciğer Sirozu Nedeniyle Takip Edilen Hastalarda Meld-Na Skoru ile Bilgisayarlı Tomografiden Elde Edilen Organometrik Ölçümler Arasındaki İlişkinin Değerlendirilmesi

Abstract

Amaç: Bilgisayarlı tomografide (BT) izlenen radyolojik görüntüleme bulguları siroz tanısında önemli bir non-invaziv yöntemdir ve prognostik değerlendirmede kullanımına ilişkin çalışmalar devam etmektedir. Çalışmamızın amacı sirotik hastaların prognozunda kullanılan MELD-Na skoru ile BT elde edilen organometrik ölçümler arasındaki korelasyonu belirlemek ve bu parametrelerin siroz prognozundaki önemini saptamaktır.
Materyal ve metod: Ocak 2016 ile Aralık 2022 tarihleri arasında yürütülen retrospektif çalışmamıza trifazik abdominal BT çekilen ve güncel MELD-Na skoru olan 52 siroz hastası dahil edildi. Bu hastaların BT görüntüleri üzerinde organometrik ölçümler kaliper yöntemi kullanılarak yapıldı. Vasküler ölçümler ana portal ven (MPV) ve hepatik venlerin sağ hepatik ven, orta hepatik ven, sol hepatik ven, hepatik venlerin toplam çapı  çapları ölçülerek yapıldı. Morfolojik ölçümler 6. ve 8. karaciğer segmentleri seviyesinde perihepatik yağ kalınlığı (PHF6 ve PHF8), hiler periportal alandaki genişleme miktarı  ve safra kesesi fossasındaki genişleme miktarı  ölçülerek elde edildi. 
Bulgular: Vasküler ölçümler ve morfolojik ölçümler ile MELD-Na skoru arasında anlamlı bir korelasyon bulunmadı (p>0,05). Sonuç: BT görüntülerinden elde edilen vasküler parametreler veya morfolojik parametreler ile sirozlu hastalarda MELD-Na skoru arasında anlamlı bir korelasyon bulunmamıştır. Bu çalışmada perihepatik yağ kalınlığı ve safra kesesi çukuru genişlemesi için yeni kantitatif ölçüm yöntemleri tanıtılmıştır. Bu ölçüm yöntemlerini doğrulamak ve sirozda BT'den elde edilen organometrik parametrelerin prognostik değerini araştırmak için daha büyük örneklem boyutlarıyla daha fazla araştırmaya ihtiyaç vardır. Anahtar Kelimeler: Siroz, Bilgisayarlı Tomografi, Organometrik Ölçüm, MELD-Na

Keywords

• Siroz
• Bilgisayarlı tomografi
• Organometrik ölçüm
• MELD-Na

Ethical Statement

This study was approved by the Atatürk University Faculty of Medicine Clinical Research Ethics Committee (approval no: 51, date: January 26, 2023).

The Evaluation of the Relationship Between Meld-Na Score and Organometric Measurements Obtained from Computed Tomography in Patients Followed for Liver Cirrhosis

Abstract

Background: The radiological imaging findings observed on computed tomography (CT) are an important non-invasive method in the diagnosis of cirrhosis, and studies are ongoing regarding their use in prognostic evaluation. The aim of our study was to determine the correlation between the MELD-Na score, used in the prognosis of cirrhotic patients, and organometric measurements obtained from CT, and to ascertain the significance of these parameters in the prognosis of cirrhosis.
Materials and Methods: Our retrospective study, conducted between January 2016 and December 2022, included 52 cirrhosis patients who underwent triphasic abdominal CT and had current MELD-Na score. Organometric measurements on the CT images of these patients were performed using the caliper method. Vascular measurements were made by measuring the diameter of the main portal vein  and hepatic veins, right hepatic vein, middle hepatic vein, left hepatic vein, total diameter hepatic veins. Morphological measurements were obtained by measuring the perihepatic fat thickness at the level of the 6th and 8th liver segments (PHF6 and PHF8), the amount of expansion in the hilar periportal space (HPPS) and the amount of expansion in the gallbladder fossa (EGF). 
Results: No significant correlation was found between vascular measurements and morphological measurements with MELD-Na score (p>0.05).
Conclusion: No significant correlation was found between vascular parameters or morphological parameters obtained from CT images and the MELD-Na score in cirrhotic patients. Novel quantitative measurement methods for perihepatic fat thickness and gallbladder fossa expansion were introduced in this study. Further research with larger sample sizes is warranted to validate these measurement methods and to investigate the prognostic value of CT-derived organometric parameters in cirrhosis.

Keywords

• Cirrhosis
• Computed tomography
• Organometric measurement
• MELD-Na

Ethical Statement

This study was approved by the Atatürk University Faculty of Medicine Clinical Research Ethics Committee (approval no: 51, date: January 26, 2023).

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