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Gastrointestinal Imaging

E3178. Changes in Liver Volumes and Their Correlation with MELD on Extended Follow-up of PSC Patients

Khoshpouri P,  Aliyari Ghasebeh M,  Ameli S,  Zargham Pour M,  Kamel I. Johns Hopkins Hospital, Baltimore, United States

Address correspondence to P. Khoshpouri (pkhoshp1@jhmi.edu)

Objective: To determine if changes in MELD score on long term follow-up of PSC patients correlate with changes in liver volumes [total liver (T), lobar (right and left; R, L), and caudate (C) volume, and ratios of L, R, and C to total liver volume (L/T, R/T, C/T)].

Materials and Methods: This HIPAA compliant, retrospective single center study included 41 PSC patients with baseline and follow-up imaging study (MR/CT) with the average of 4-year interval between 2000 and 2017. T, L, R, and C were measured using Advantage Workstation (GE) on both imaging studies for each case. L/T, R/T, C/T, and MELD score were then calculated at both baseline and follow-up studies. Patients were stratified into group A (low baseline MELD; <10) and group B (high baseline MELD; =10) to assess the differences in baseline and follow up liver volumes using t test. P value <0.05 was considered significant.

Results: Our cohort included 27 males and 14 females with the mean age of 42 at baseline and 46 at follow-up, with no significant differences in age between males and females. Group A with low baseline MELD had ratios of L/T, R/T, and C/T of 0.4, 0.6, and 0.026, respectively at baseline study. L/T and R/T along with MELD score changed significantly at follow up study (p<0.05) but the other values remained stable. In group B with high baseline MELD, baseline total, left lobe, and caudate volumes were significantly higher than in group A (p<0.05); right lobe was normal, and ratios of L/T, R/T, and C/T were significantly different from group A (0.56, 0.44, 0.086, respectively) (p<0.005). In group B MELD remained stable over time; none of the volumes and ratios changed significantly at follow up study (p=ns)

Conclusion: Patients with low baseline MELD had 40/60 ratios of L/R whereas patients with high baseline MELD had significant reversal of this ratio (53/47) and doubling of the caudate volume. In both low and high baseline MELD groups there was no change in volume over extended follow up, except for the ratio of lobar to total volume in the low baseline MELD group. In this group worsening MELD may have resulted in changes in lobar volume ratios. Patients with low baseline MELD demonstrated rising MELD on extended follow up, with corresponding changes in lobar liver volume ratios. Patients with high baseline MELD had abnormal liver volumes (except right lobe) and lobar volume ratios at baseline. MELD, liver volumes and volume ratios remained stable over extended follow up.