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Cirrhosis: Modified Caudate–Right Lobe Ratio¹

¹ From the Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, 1096 Main Bldg, Philadelphia, PA 19107. Received September 7, 2001; revision requested November 8; revision received December 19; accepted January 29, 2002. Address correspondence to D.G.M. (e-mail: donald.mitchell@mail.tju.edu).

PURPOSE: To determine whether a modified caudate–right lobe ratio (C/RL) with use of the right portal vein to set the lateral boundary (C/RL-r) is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is the previously described C/RL with use of the main portal vein to set the lateral boundary (C/RL-m).

MATERIALS AND METHODS: Two hundred thirty-six patients (121 with pathologically proved cirrhosis and 115 without history of chronic hepatic diseases) underwent magnetic resonance (MR) imaging. Two independent observers measured C/RL-r and compared it with C/RL-m. Results were compared by using receiver operating characteristic (ROC) curves and accuracy measures at various thresholds.

RESULTS: The area below the ROC curve was greater for C/RL-r (0.797) than for C/RL-m (0.731; P = .040). By using a C/RL-r greater than 0.90, the sensitivity, specificity, and accuracy for the MR imaging diagnosis of cirrhosis were 71.7%, 77.4%, and 74.2%, respectively. The highest accuracy of the C/RL-m was 65.7%, when the C/RL-m was greater than 0.55. Interobserver agreement was statistically confirmed for both measurements by using analysis. Significant differences were found among the three Child-Pugh classes by using C/RL-r (P = .0105) but not by using C/RL-m.

CONCLUSION: C/RL-r is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is C/RL-m.

© RSNA, 2002

Index terms: Liver, cirrhosis, 761.794 • Liver, MR, 761.121411, 761.121412, 761.121415, 761.12143 • Liver, size

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