Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis

Sang Jung Park, Jin Dong Kim, Yeon Seok Seo, Beom Jin Park, Min Ju Kim, Soon Ho Um, Chang Ha Kim, Hyung Joon Yim, Soon Koo Baik, Jin Yong Jung, Bora Keum, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu

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Abstract

AIM: To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. METHODS: 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. RESULTS: 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. CONCLUSION: In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.

Original languageEnglish
Pages (from-to)2543-2549
Number of pages7
JournalWorld Journal of Gastroenterology
Volume19
Issue number16
DOIs
Publication statusPublished - 2013 Apr 1

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Cholestasis
Hepatitis
Gallbladder
Odds Ratio
Tomography
Bilirubin
Ascites
Albumins
Lymph Nodes
Chemical and Drug Induced Liver Injury
Hepatitis A virus
Prothrombin Time
Alanine Transaminase
Alkaline Phosphatase
Hospitalization
Spleen
Multivariate Analysis
Logistic Models
Liver
Serum

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Park, S. J., Kim, J. D., Seo, Y. S., Park, B. J., Kim, M. J., Um, S. H., ... Ryu, H. S. (2013). Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. World Journal of Gastroenterology, 19(16), 2543-2549. https://doi.org/10.3748/wjg.v19.i16.2543
Park, Sang Jung ; Kim, Jin Dong ; Seo, Yeon Seok ; Park, Beom Jin ; Kim, Min Ju ; Um, Soon Ho ; Kim, Chang Ha ; Yim, Hyung Joon ; Baik, Soon Koo ; Jung, Jin Yong ; Keum, Bora ; Jeen, Yoon Tae ; Lee, Hong Sik ; Chun, Hoon Jai ; Kim, Chang Duck ; Ryu, Ho Sang. / Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. In: World Journal of Gastroenterology. 2013 ; Vol. 19, No. 16. pp. 2543-2549.
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title = "Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis",
abstract = "AIM: To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. METHODS: 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. RESULTS: 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. CONCLUSION: In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.",
author = "Park, {Sang Jung} and Kim, {Jin Dong} and Seo, {Yeon Seok} and Park, {Beom Jin} and Kim, {Min Ju} and Um, {Soon Ho} and Kim, {Chang Ha} and Yim, {Hyung Joon} and Baik, {Soon Koo} and Jung, {Jin Yong} and Bora Keum and Jeen, {Yoon Tae} and Lee, {Hong Sik} and Chun, {Hoon Jai} and Kim, {Chang Duck} and Ryu, {Ho Sang}",
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Park, SJ, Kim, JD, Seo, YS, Park, BJ, Kim, MJ, Um, SH, Kim, CH, Yim, HJ, Baik, SK, Jung, JY, Keum, B, Jeen, YT, Lee, HS, Chun, HJ, Kim, CD & Ryu, HS 2013, 'Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis', World Journal of Gastroenterology, vol. 19, no. 16, pp. 2543-2549. https://doi.org/10.3748/wjg.v19.i16.2543

Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. / Park, Sang Jung; Kim, Jin Dong; Seo, Yeon Seok; Park, Beom Jin; Kim, Min Ju; Um, Soon Ho; Kim, Chang Ha; Yim, Hyung Joon; Baik, Soon Koo; Jung, Jin Yong; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon Jai; Kim, Chang Duck; Ryu, Ho Sang.

In: World Journal of Gastroenterology, Vol. 19, No. 16, 01.04.2013, p. 2543-2549.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis

AU - Park, Sang Jung

AU - Kim, Jin Dong

AU - Seo, Yeon Seok

AU - Park, Beom Jin

AU - Kim, Min Ju

AU - Um, Soon Ho

AU - Kim, Chang Ha

AU - Yim, Hyung Joon

AU - Baik, Soon Koo

AU - Jung, Jin Yong

AU - Keum, Bora

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Chun, Hoon Jai

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

PY - 2013/4/1

Y1 - 2013/4/1

N2 - AIM: To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. METHODS: 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. RESULTS: 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. CONCLUSION: In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.

AB - AIM: To evaluate the significance of computed tomography (CT) findings in relation to liver chemistry and the clinical course of acute hepatitis. METHODS: 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. RESULTS: 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. CONCLUSION: In patients with acute hepatitis, GWT on CT scan was an independent predictor of severe hepatitis and prolonged cholestasis.

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