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Diagnosis of Alcoholic Cirrhosis with the Right-to-Left Hepatic Lobe Ratio: Concise Communication

Veterans Administration Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Correspondence: For reprints contact: D. P. Shreiner, MD, Chief, Nuclear Medicine Service, Veterans Administration Med. Ctr., University Dr. C, Pittsburgh, PA 15240.

ABSTRACT

Since scans of cirrhotic livers commonly show a reduction in size and colloid uptake of the right lobe, a quantitative measure of uptake was made using a mini computer to determine total counts in regions of interest defined over each lobe. Right-to-left ratios were then compared in 103 patients. For normal patients the mean ratio ± 1 s.d. was 2.85 ± 0.65, and the mean for patients with known cirrhosis was 1.08 ± 0.33. Patients with other liver diseases had ratios similar to the normal group. The normal range of the right-to-left lobe ratio was 1.55–4.15. The sensitivity of the ratio for alcoholic cirrhosis was 85.7% and the specificity was 100% in this patient population. The right-to-left lobe ratio was more sensitive and specific for alcoholic cirrhosis than any other criterion tested. An hypothesis is described to explain these results.