CT Features of Hepatic Veno-occlusive Disease: A Meta-analysis

Acad Radiol. 2018 Mar;25(3):328-337. doi: 10.1016/j.acra.2017.10.012. Epub 2017 Nov 27.

Abstract

Rationale and objective: The computed tomography (CT) features of hepatic veno-occlusive disease (HVOD) could play a role in its diagnosis. We aimed to perform a meta-analysis of studies examining the CT features of HVOD.

Methods: Relevant studies published up to May 3, 2017 were searched in major electronic databases. The extracted data included the proportion of various CT features in patients with HVOD. The meta-analysis was conducted using R 3.3.3 with the "meta" package.

Results: Eleven studies were included. The studies involved 326 patients with a mean age range of 50.2-58.9 years, and the proportion of female patients ranged from 20% to 57.5%. The meta-analysis showed the pooled proportion of CT features: hepatic parenchyma with heterogeneous hypoattenuation (81.05%, 95% confidence interval [CI]: 56.97%-93.25%), patchy enhancement in the portal venous phase (87.09%, 95% CI: 75.15%-93.77%) with or without a narrow or invisible hepatic vein (71.02% 95% CI: 42.09%-89.20%), gallbladder wall edema (65.51%, 95% CI: 28.98%-89.84%), and patchy heterogeneous enhancement in the arterial phase (44.36%, 95% CI: 29.98%-59.76%) with or without slightly enlarged hepatic artery (56.61%, 95% CI: 40.62%-71.33%).

Conclusion: Hepatic parenchyma with heterogeneous hypoattenuation and patchy enhancement with or without narrowing or an invisible hepatic vein in the portal venous or equilibrium phase may be the most important CT feature for diagnosing HVOD.

Keywords: CT; HSOS; HVOD; acute stage; meta-analysis; pyrrolizidine alkaloid.

Publication types

  • Meta-Analysis

MeSH terms

  • Female
  • Hepatic Artery / diagnostic imaging
  • Hepatic Veins / diagnostic imaging
  • Hepatic Veno-Occlusive Disease / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Portal Vein / diagnostic imaging
  • Tomography, X-Ray Computed*