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KMID : 1148020170420020044
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조선대학교의대논문집
2017 Volume.42 No. 2 p.44 ~ p.50
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Appearance of the Hypodense Liver Nodules in Alcoholic Liver Cirrhosis during Computed Tomography: Association with Acute Alcoholic Steatohepatitis
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Byun Joo-Nam
Kim Dong-Hun
Yoon Eun-Ju
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Abstract
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This study was undertaken to evaluate the association between the appearance of hypodense hepatic nodules on dynamic CT images and acute alcoholic hepatitis in patients with alcoholic cirrhosis. Sixty-two patients (male:female=57:5, mean age=51.4±10.9 years) with alcoholic cirrhosis were included. Patients were divided into 3 groups; group A (nodules, n=23), group B (fatty liver < 40 Hounsfield unit (HU) without nodules, n=18), and group C (control, n=21). Liver nodules in Group A had characteristic low density during pre- and all post-contrast phases versus liver parenchyma and fewer or complete resolution of nodules on follow up CT after alcohol withdrawal. Densities (HU) of nodules and hepatic parenchyma, ascites scores, and laboratory values were analyzed. Mean densities of hepatic parenchyma in groups A and B were significantly lower than in the control group. Serum bilirubin, AST (aspartate transaminase), ALT (alanine transaminase), PT (prothrombin time), and ascites scores were significantly higher in group A than in the other two groups. As numbers of liver nodules increased nodules’ attenuation decreased. Mean serum AST and ALT were higher in patients with many nodules than in patients with few nodules. Hypodense hepatic nodules in alcoholic steatohepatitis in patients with alcoholic cirrhosis are probably benign nodules resulting from focal steatosis or hepatocellular necrosis rather than metastases.
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KEYWORD
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Alcoholic liver cirrhosis, Acute alcoholic hepatitis, Pseudotumoral hepatic lesions, Computed tomography, Alcoholic liver disease
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