Polycystic liver disease: Quantitation of parenchymal and cyst volumes from computed tomography images and clinical correlates of hepatic cysts

Authors

  • Dr. Gregory T. Everson M.D.,

    Corresponding author
    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
    • Division of Gastroenterology, University of Colorado Health Sciences Center, 4200 East Ninth Ave. (Box B-158), Denver, Colorado 80262
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    • Dr. Everson was supported in part by a National Institutes of Health Clinical Investigator Award (K08-AM01156), by a Research and Teaching Scholar Award from the American College of Physicians, by a National Institutes of Health individual investigator award (R01-DK19605) and by the University of Colorado Hepatobiliary Center (U. S. Public Health Service Grant DK34914).

  • Ann Scherzinger,

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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  • Nancy Berger-Leff,

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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  • Juerg Reichen,

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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  • Dennis Lezotte,

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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  • Michael Manco-Johnson,

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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  • Patricia Gabow

    1. Departments of Medicine, Radiology, Biometrics and the Hepatobiliary Center of the University of Colorado School of Medicine, Denver, Colorado 80262
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Abstract

Polycystic liver disease is a common manifestation of autosomal dominant polycystic kidney disease. However, factors that regulate hepatic cystogenesis have not been defined, and the effect of cyst formation on hepatic parenchymal mass has not been studied. We validated computed tomographic methods for measuring volumes from computed tomographic images using plastic-agar models and demonstrated that measured volumes were within 10% of actual volumes. The validated methods were used to measure hepatic parenchymal, hepatic cyst and kidney volumes in 25 subjects with polycystic liver disease and nine controls without autosomal dominant polycystic kidney disease. Hepatic cyst volume varied considerably in the 25 subjects with polycystic liver disease (20 to 7,148 ml), but hepatic parenchymal volume was not altered by hepatic cysts and was similar to that of controls (polycystic liver disease vs. controls: 1,357 ± 185 vs. 1,319 + 340 ml). Total liver volume increased linearly as cyst volume increased (slope = 1.02 ± 0.05, r = 0.994). Nine of 18 women with polycystic liver disease had massive hepatic cysts (cyst:paren-chymal volume >1; range of cyst volumes from 1,354 to 7,148 ml), and the other nine had cyst volumes (20 to 399 ml) similar to men with polycystic liver disease (25 to 1,107 ml). Total kidney volume, a measure of renal cystic disease, did not correlate with either total liver volume or the volume of hepatic cysts. The data indicate that hepatic parenchymal volume is preserved in polycystic liver disease despite massive cystic involvement and that women are uniquely susceptible to massive hepatic cystic disease.

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