Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis

• Published in: World journal of gastroenterology : WJG Vol. 19; no. 16; pp. 2543 - 2549
• Main Author: Park, Sang Jung
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 28.04.2013
• Subjects: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers - blood; Brief; Chi-Square Distribution; Child; Cholestasis - blood; Cholestasis - diagnostic imaging; Cholestasis - etiology; Female; Hepatitis, Viral, Human - blood; Hepatitis, Viral, Human - complications; Hepatitis, Viral, Human - diagnostic imaging; Humans; Linear Models; Logistic Models; Male; Middle Aged; Multidetector Computed Tomography; Multivariate Analysis; Odds Ratio; Predictive Value of Tests; Prothrombin Time; Retrospective Studies; Risk Factors; Severity of Illness Index; Time Factors; Young Adult; Gallbladder; Acute hepatitis; Prognosis; Computed tomography; Cholestasis
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v19.i16.2543

To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. Four hundred and twelve patients with acute hepatitis who underwent enhanced CT scanning were enrolled retrospectively. Imaging findings were analyzed for the following variables: gallbladder wall thickness (GWT), arterial heterogeneity, periportal tracking, number and maximum size of lymph nodes, presence of ascites, and size of spleen. The serum levels of alanine aminotransferase, alkaline phosphatase, bilirubin, albumin, and prothrombin time were measured on the day of admission and CT scan, and laboratory data were evaluated every 2-4 d for all subjects during hospitalization. The mean age of patients was 34.4 years, and the most common cause of hepatitis was hepatitis A virus (77.4%). The mean GWT was 5.2 mm. The number of patients who had findings of arterial heterogeneity, periportal tracking, lymph node enlargement > 7 mm, and ascites was 294 (80.1%), 348 (84.7%), 346 (84.5%), and 56 (13.6%), respectively. On multivariate logistic regression, male gender [odds ratio (OR) = 2.569, 95%CI: 1.477-4.469, P = 0.001], toxic hepatitis (OR = 3.531, 95%CI: 1.444-8.635, P = 0.006), level of albumin (OR = 2.154, 95%CI: 1.279-3.629, P = 0.004), and GWT (OR = 1.061, 95%CI: 1.015-1.110, P = 0.009) were independent predictive factors for severe hepatitis. The level of bilirubin (OR = 1.628, 95%CI: 1.331-1.991, P < 0.001) and GWT (OR = 1.172, 95%CI: 1.024-1.342, P = 0.021) were independent factors for prolonged cholestasis in multivariate analysis. In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.