BibTex RIS Kaynak Göster

The value of computed tomography in determining the percentage of hepatosteatosis: An experimental animal study

Yıl 2013, Cilt: 12 Sayı: 3, 89 - 94, 01.12.2013

Öz

Background and Aims:To analyze the degree of hepatosteatosis and computed tomography findings experimentally using the mouse liver to create computed tomography indexes for determining the degree of hepatosteatosis of the donor liver. Materials and Methods:Forty Swiss Albino mice were obtained. Whole body computed tomography scans were obtained by Picker MxTwin four-slice multidetector computed tomography device. To induce hepatosteatosis, the mice were fed by oral gavage with 0,06 mL CCl 4 plus 0,04 mL corn oil, totally 0,1 mL, in 2500 mg/kg/day CCl4 dosages. The study was continued for four weeks. The computed tomography density measurements were obtained by taking the average of three different 0,5 cm 2 areas in every organ. Data were compared with pathology. The livers, spleens, kidneys, and paravertebral muscles of the mice were removed. Five-micron thick slices from the paraffin blocks were mounted to slides. An interactive image analysis system (Aequitas, Dynamic Data Links) was used to measure the degree of steatosis in the liver specimens. For each specimen, the proportion of liver with steatosis was determined. Results were assessed statistically. Results:A reduction of 40 Hounsfield units in liver density indicates 30% hepatosteatosis. There was a statistically significant correlation between the liver/spleen, liver/kidney and liver/ muscle ratios and the histomorphometric hepatosteatosis percentage. When the liver/spleen ratio is ≤0,32, the critical value for the transplantation of ≥30% hepatosteatosis must be doubted. Conclusions:With the measurement of the liver/spleen ratio, the total hepatosteatosis percentage can be calculated according to a formula, which we introduce herein, based on our experimental study.

Kaynakça

  • Broelsch CE, Whitington PF, Emond JC, et al. Liver transplantation in children from living related donors: surgical techniques and re- sults. Ann Surg 1994; 214: 428-39.
  • Lucey MR, Merion RM, Henley KS, et al. Selection for and outcome of liver transplantation in alcoholic liver disease. Gastroenterology 1992; 102: 1736-42.
  • Odze RD, Goldblum JR. Surgical pathology of the GI tract, liver, biliary tract and pancreas. Philadelphia: Saunders Elsevier, 2009; 1177.
  • Ma X, Holalkere NS, Kambadakone RA, Mino-Kenudson M, Hahn PF, Sahani DV. Imaging-based quantification of hepatic fat: meth- ods and clinical applications. Radiographics 2009; 29: 1253-77.
  • Wang B, Gao Z, Zou Q, Li L. Quantitative diagnosis of fatty liver with dual-energy CT. An experimental study in rabbits. Acta Radiol 2003; 44: 92-7.
  • Ferrell LD. Liver pathology. New York: Deswmomedical, 2011; 165.
  • D’Alessandro AM, Kalayoglu M, Sollinger HW, et al. The predic- tive value of donor liver biopsies on the development of primary nonfunction after orthotopic liver transplantation. Transplant Proc 1991; 23: 1536-7.
  • Gabrielli M, Moisan F, Vidal M, et al. Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study. Ann Hepatol 2012; 11: 891-8.
  • McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver trans- plantation using fatty livers: always feasible? J Hepatol 2011; 54: 1055-62.
  • McCormack L, Petrowsky H, Jochum W, Mullhaupt B, Weber M, Clavien PA. Use of severely steatotic grafts in liver transplantation: a matched case-control study. Ann Surg 2007; 246: 940-6.
  • Salizzoni M, Franchello A, Zamboni F, et al. Marginal grafts: finding the correct treatment for fatty livers. Transpl Int 2003; 16: 486-93.
  • Zamboni F, Franchello A, David E, et al. Effect of macrovesicular steatosis and other donor and recipient characteristics on the out- come of liver transplantation. Clin Transplant 2001; 15: 53-7.
  • Urena MA, Moreno Gonzalez E, Romero CJ, Ruiz-Delgado FC, Moreno Sanz C. An approach to the rational use of steatotic donor livers in liver transplantation. Hepatogastroenterology 1999; 46: 1164-73.
  • Nocito A, El-Badry AM, Clavien PA. When is steatosis too much for transplantation? J Hepatol 2006; 45: 494-9.
  • Koneru B, Dikdan G. Hepatic steatosis and liver transplantation cur- rent clinical and experimental perspectives. Transplantation 2002; 73: 325-30.
  • Dutkowski P, Schlegel A, Slankamenac K, et al. The use of fatty liver grafts in modern allocation systems: risk assessment by the balance of risk (BAR) score. Ann Surg 2012; 256: 861-8.
  • Fishbein TM, Fiel MI, Emre S, et al. Use of livers with microvesicu- lar fat safely expands the donor pool. Transplantation 1997; 64: 248-51.
  • Cieslak B, Lewandowski Z, Urban M, Ziarkiewicz-Wróblewska B, Krawczyk M. Microvesicular liver graft steatosis as a risk factor of initial poor function in relation to suboptimal donor parameters. Transplant Proc 2009; 41: 2985-8.
  • Sharkey FE, Lytvak I, Prihoda TJ, Speeg KV, Washburn WK, Halff GA. High-grade microsteatosis and delay in hepatic function after orthotopic liver transplantation. Hum Pathol 2011; 42: 1337-42.
  • Selzner M, Clavien PA. Fatty liver in liver transplantation and sur- gery. Semin Liver Dis 2001; 21: 105-13.
  • Garcia Urena MA, Colina Ruiz-Delgado F, Moreno Gonzalez E, et al. Hepatic steatosis in liver transplant donors: common feature of donor population? World J Surg 1998; 22: 837-44.
  • Ahn JS, Sinn DH, Gwak GY, et al. Steatosis among living liver do- nors without evidence of fatty liver on ultrasonography: potential implications for preoperative liver biopsy. Transplantation 2013; 95: 1404-9.
  • Rinella ME, Alonso E, Rao S, et al. Body mass index as a predictor of hepatic steatosis in living liver donors. Liver Transpl 2001; 7: 409-14.
  • Hornboll P, Olsen TS. Fatty changes in the liver: the relation to age, overweight and diabetes mellitus. Acta Pathol Microbiol Immunol Scand [A] 1982; 90: 199-205.
  • Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatol- ogy 1999; 30: 1356-62.
  • Adam R, Reynes M, Johann M, et al. The outcome of steatotic grafts in liver transplantation. Transplant Proc 1991; 23: 1538-40.
  • Lee MJ, Bagci P, Kong J, et al. Liver steatosis assessment: corre- lations among pathology, radiology, clinical data and automated image analysis software. Pathol Res Pract 2013; 209: 371-9.
  • Scott WW Jr, Sanders RC, Siegelman SS. Irregular fatty infiltration of the liver: diagnostic dilemmas. AJR Am J Roentgenol 1980; 135: 67-71.
  • Joy D, Thava VR, Scott BB. Diagnosis of fatty liver disease: is biopsy necessary? Eur J Gastroenterol Hepatol 2003; 15: 539-43.
  • Noworolski SM, Lam MM, Merriman RB, Ferrell L, Qayyum A. Liver steatosis: concordance of MR imaging and MR spectroscopic data with histologic grade. Radiology 2012; 264: 88-96.
  • Idilman IS, Aniktar H, Idilman R, et al. Hepatic steatosis: quantifica- tion by proton density fat fraction with MR imaging versus liver biopsy. Radiology 2013; 267: 767-75.
  • Siegelman ES, Rosen MA. Imaging of hepatic steatosis. Semin Liver Dis 2001; 21: 71-80.
  • Ricci C, Longo R, Gioulis E, et al. Noninvasive in vivo quantitative as- sessment of fat content in human liver. J Hepatol 1997; 27: 108-13.
  • Cheng YF, Chen CL, Lai CY, et al. Assessment of donor fatty livers for liver transplantation. Transplantation 2001; 71: 1221-5.
  • Karçaaltıncaba M, Aktaş A. Dual-energy CT revisited with multide- tector CT: review of principles and clinical applications. Diagn Interv Radiol 2011; 17: 181-94.

Karaciğer yağlanmasının yüzdesinin tespit edilmesinde bilgisayarlı tomografinin önemi: Deneysel hayvan çalışması

Yıl 2013, Cilt: 12 Sayı: 3, 89 - 94, 01.12.2013

Öz

Giriş ve Amaç:Verici karaciğerinin yağlanma derecesinin tespit edilmesi için fare karaciğerlerini kullanmak suretiyle bilgisayarlı tomografi indeksleri oluşturarak deneysel olarak yağlanma derecesinin ve bilgisayarlı tomografi bulgularının analizi. Gereç ve Yöntem:Kırk adet Swiss Albino fare elde edildi. Picker MxTwin marka 4 kesitli multidedektör bilgisayarlı tomografi cihazı kullanılarak farelerin tüm vücut tomografik incelemeleri sağlandı. Fareler 0,06 mL CCl 4 M ve buna ek olarak 0,04 mL mısırözü yağı ile toplam 0,1 mL olacak şekilde 2500 mg/kg/gün CCl4 C dozunda oral gavaj ile beslendi ve karaciğer yağlanması oluşturulmaya çalışıldı. Çalışma 4 hafta sürdü. Bilgisayarlı tomografi dansite ölçümleri, her organdan alınan farklı üç 0,5 cm 2 'lik alanın ortalaması alınarak elde edildi. Veriler patoloji ile karşılaştırıldı. Farelerin karaciğerleri, dalakları, böbrekleri, paravertebral kasları çıkarıldı. Parafin bloklardan elde edilen 5 mikron kalınlığındaki kesitler lama aktarıldı. Karaciğer örneklerindeki yağlanma miktarının ölçümü için interaktif imaj analiz sistemi (Aequitas, Dynamic Data Links) kullanıldı. Her örnek için karaciğer yağlanma oranı belirlendi. Sonuçlar istatistiksel olarak değerlendirildi. Bulgular: Karaciğer dansitesindeki 40 Hounsfield ünitelik azalma %30'luk karaci-ğer yağlanmasına denk gelmektedir. Karaciğer/dalak, karaciğer/böbrek ve karaciğer/kas dansite değerleri ile histomorfometrik karaciğeryağ-lanması oranı arasında istatistiksel olarak anlamlı bir korelasyon vardı. Karaciğer/dalak bilgisayarlı tomografi dansite oranı 0,32 ve altında olduğunda, transplantasyonda karaciğer yağlanması için kritik değer olan %30 ve üzeri değerden şüphelenilmelidir. Sonuç:Bu deneysel çalışmada ortaya koyduğumuz formülle, karaciğer/dalak dansite oranı ölçümü ile total karaciğer yağlanması hesaplanabilir.

Kaynakça

  • Broelsch CE, Whitington PF, Emond JC, et al. Liver transplantation in children from living related donors: surgical techniques and re- sults. Ann Surg 1994; 214: 428-39.
  • Lucey MR, Merion RM, Henley KS, et al. Selection for and outcome of liver transplantation in alcoholic liver disease. Gastroenterology 1992; 102: 1736-42.
  • Odze RD, Goldblum JR. Surgical pathology of the GI tract, liver, biliary tract and pancreas. Philadelphia: Saunders Elsevier, 2009; 1177.
  • Ma X, Holalkere NS, Kambadakone RA, Mino-Kenudson M, Hahn PF, Sahani DV. Imaging-based quantification of hepatic fat: meth- ods and clinical applications. Radiographics 2009; 29: 1253-77.
  • Wang B, Gao Z, Zou Q, Li L. Quantitative diagnosis of fatty liver with dual-energy CT. An experimental study in rabbits. Acta Radiol 2003; 44: 92-7.
  • Ferrell LD. Liver pathology. New York: Deswmomedical, 2011; 165.
  • D’Alessandro AM, Kalayoglu M, Sollinger HW, et al. The predic- tive value of donor liver biopsies on the development of primary nonfunction after orthotopic liver transplantation. Transplant Proc 1991; 23: 1536-7.
  • Gabrielli M, Moisan F, Vidal M, et al. Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study. Ann Hepatol 2012; 11: 891-8.
  • McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver trans- plantation using fatty livers: always feasible? J Hepatol 2011; 54: 1055-62.
  • McCormack L, Petrowsky H, Jochum W, Mullhaupt B, Weber M, Clavien PA. Use of severely steatotic grafts in liver transplantation: a matched case-control study. Ann Surg 2007; 246: 940-6.
  • Salizzoni M, Franchello A, Zamboni F, et al. Marginal grafts: finding the correct treatment for fatty livers. Transpl Int 2003; 16: 486-93.
  • Zamboni F, Franchello A, David E, et al. Effect of macrovesicular steatosis and other donor and recipient characteristics on the out- come of liver transplantation. Clin Transplant 2001; 15: 53-7.
  • Urena MA, Moreno Gonzalez E, Romero CJ, Ruiz-Delgado FC, Moreno Sanz C. An approach to the rational use of steatotic donor livers in liver transplantation. Hepatogastroenterology 1999; 46: 1164-73.
  • Nocito A, El-Badry AM, Clavien PA. When is steatosis too much for transplantation? J Hepatol 2006; 45: 494-9.
  • Koneru B, Dikdan G. Hepatic steatosis and liver transplantation cur- rent clinical and experimental perspectives. Transplantation 2002; 73: 325-30.
  • Dutkowski P, Schlegel A, Slankamenac K, et al. The use of fatty liver grafts in modern allocation systems: risk assessment by the balance of risk (BAR) score. Ann Surg 2012; 256: 861-8.
  • Fishbein TM, Fiel MI, Emre S, et al. Use of livers with microvesicu- lar fat safely expands the donor pool. Transplantation 1997; 64: 248-51.
  • Cieslak B, Lewandowski Z, Urban M, Ziarkiewicz-Wróblewska B, Krawczyk M. Microvesicular liver graft steatosis as a risk factor of initial poor function in relation to suboptimal donor parameters. Transplant Proc 2009; 41: 2985-8.
  • Sharkey FE, Lytvak I, Prihoda TJ, Speeg KV, Washburn WK, Halff GA. High-grade microsteatosis and delay in hepatic function after orthotopic liver transplantation. Hum Pathol 2011; 42: 1337-42.
  • Selzner M, Clavien PA. Fatty liver in liver transplantation and sur- gery. Semin Liver Dis 2001; 21: 105-13.
  • Garcia Urena MA, Colina Ruiz-Delgado F, Moreno Gonzalez E, et al. Hepatic steatosis in liver transplant donors: common feature of donor population? World J Surg 1998; 22: 837-44.
  • Ahn JS, Sinn DH, Gwak GY, et al. Steatosis among living liver do- nors without evidence of fatty liver on ultrasonography: potential implications for preoperative liver biopsy. Transplantation 2013; 95: 1404-9.
  • Rinella ME, Alonso E, Rao S, et al. Body mass index as a predictor of hepatic steatosis in living liver donors. Liver Transpl 2001; 7: 409-14.
  • Hornboll P, Olsen TS. Fatty changes in the liver: the relation to age, overweight and diabetes mellitus. Acta Pathol Microbiol Immunol Scand [A] 1982; 90: 199-205.
  • Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatol- ogy 1999; 30: 1356-62.
  • Adam R, Reynes M, Johann M, et al. The outcome of steatotic grafts in liver transplantation. Transplant Proc 1991; 23: 1538-40.
  • Lee MJ, Bagci P, Kong J, et al. Liver steatosis assessment: corre- lations among pathology, radiology, clinical data and automated image analysis software. Pathol Res Pract 2013; 209: 371-9.
  • Scott WW Jr, Sanders RC, Siegelman SS. Irregular fatty infiltration of the liver: diagnostic dilemmas. AJR Am J Roentgenol 1980; 135: 67-71.
  • Joy D, Thava VR, Scott BB. Diagnosis of fatty liver disease: is biopsy necessary? Eur J Gastroenterol Hepatol 2003; 15: 539-43.
  • Noworolski SM, Lam MM, Merriman RB, Ferrell L, Qayyum A. Liver steatosis: concordance of MR imaging and MR spectroscopic data with histologic grade. Radiology 2012; 264: 88-96.
  • Idilman IS, Aniktar H, Idilman R, et al. Hepatic steatosis: quantifica- tion by proton density fat fraction with MR imaging versus liver biopsy. Radiology 2013; 267: 767-75.
  • Siegelman ES, Rosen MA. Imaging of hepatic steatosis. Semin Liver Dis 2001; 21: 71-80.
  • Ricci C, Longo R, Gioulis E, et al. Noninvasive in vivo quantitative as- sessment of fat content in human liver. J Hepatol 1997; 27: 108-13.
  • Cheng YF, Chen CL, Lai CY, et al. Assessment of donor fatty livers for liver transplantation. Transplantation 2001; 71: 1221-5.
  • Karçaaltıncaba M, Aktaş A. Dual-energy CT revisited with multide- tector CT: review of principles and clinical applications. Diagn Interv Radiol 2011; 17: 181-94.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Fahrettin Küçükay Bu kişi benim

Kemal Arda Bu kişi benim

Rıza Sarper Ökten Bu kişi benim

Nesrin Turhan Bu kişi benim

Mustafa Özdemir Bu kişi benim

Melih Ereren Bu kişi benim

Hasan Büyük Bu kişi benim

Adnan Karan Bu kişi benim

Erdal Birol Bostancı Bu kişi benim

Erkan Parlak Bu kişi benim

Eyüp Şenol Bu kişi benim

Muharrem Tola Bu kişi benim

Gökhan Yüce Bu kişi benim

Meral Akdoğan Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 12 Sayı: 3

Kaynak Göster

APA Küçükay, F., Arda, K., Ökten, R. S., Turhan, N., vd. (2013). Karaciğer yağlanmasının yüzdesinin tespit edilmesinde bilgisayarlı tomografinin önemi: Deneysel hayvan çalışması. Akademik Gastroenteroloji Dergisi, 12(3), 89-94.

test-5