CORRELATION BETWEEN LIVER SEGMENTAL ANATOMY AND THE PATTERN OF HEPATIC INVOLVEMENT IN CHRONIC HEPATITIS B PATIENTS
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Keywords
Chronic hepatitis B, liver segments, Couinaud classification, hepatic involvement, fibrosis
Abstract
Background: Chronic hepatitis B virus (HBV) infection can lead to progressive liver damage and complications, but the distribution of hepatic involvement across different liver segments remains understudied.
Objective: To evaluate the correlation between liver segmental anatomy and the pattern of hepatic involvement in patients with chronic hepatitis B using radiological imaging. Methods: This descriptive cross-sectional study was conducted at private hospitals of Karachi from October 2024 to March 2025. A total of 198 patients diagnosed with chronic hepatitis B were included in the study through non-probability consecutive sampling. After obtaining informed consent, demographic and clinical data including age, sex, duration of HBV infection, liver function test results, and antiviral treatment history were recorded using a structured proforma.
Results: The mean age was 44.6 ± 11.2 years; 62.6% were male. Segment VI was the most commonly involved (71.7%), followed by segments VII (65.2%) and V (63.1%), whereas segment I was least involved (14.1%). Patients with moderate-to-severe disease showed significantly higher involvement of posterior segments (p < 0.001). Fibrosis was most prevalent in segments VI (76.5%) and VII (67.6%). Regenerative nodules were predominantly found in segment VIII (57.1%). Inter-observer agreement for segmental analysis was substantial (Cohen’s Kappa = 0.81).
Conclusion: It is concluded that chronic HBV infection exhibits a preferential pattern of hepatic involvement, predominantly affecting posterior liver segments. Segmental imaging evaluation can aid in early recognition of disease progression and may enhance personalized management strategies for HBV patients.
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Dr Qurat ul Ain Khan
Assistant professor anatomy department, Liaquat College of medicine and dentistry
Dr Talat Yasmeen
Professor Anatomy, Liaquat College of Medicine and Dentistry
Dr Samar Ekram
Senior Registrar of Medicine, Liaquat College of Medicine and Dentistry
Gulraiz Karim Rind Baloch
Assistant Professor Anatomy, Ziauddin University, Karachi
Dr Madiha Imtiaz
Assistant consultant radiologist, Islamabad Diagnostic center
Dr Farah Malik
Assistant professor anatomy, Liaquat College of medicine and dentistry
Emaan Mansoor
Department of Dental Material Sciences, Islamic International Dental college, Riphah International University, Islamabad
Ezza Mansoor
Department of Dental Material Sciences, Islamic International Dental college, Riphah International University, Islamabad
Efrah Mansoor
Department of Dental Material Sciences, Islamic International Dental college, Riphah International University, Islamabad
Dr Afsheen Mansoor
Associate Professor, Department of Dental material Sciences, School of Dentistry, Shaheed Zulfiqar Ali Bhutto medical University, Islamabad. Department of Microbiology and Nanotechnology, Quaid-i-Azam University, Islamabad.