Abstract: Objective The aim of this study was to investigate the hepatic extracellular volume fractions (fECV) measured by CT scan as a novel noninvasive marker for significant liver fibrosis and cirrhosis in patients with chronic hepatitis B virus infection. Methods A total of 138 patients with chronic hepatitis B (CHB) were recruited in our hospital between January 2015 and January 2020, and all underwent routine multi-stage enhanced liver CT scan and liver biopsies. The fECV were measured. The ROC curve and the area under the curve (AUC) were calculated and the sensitivity, specificity and accuracy were obtained. Results Out of our series of 138 patients with CHB, the histopathological examination showed the F0 in 14, F1 in 28, F2 in 45, F3 in 36 and F4 in 15, e.g. F0-1 in 42, F2-4 in 96 and F3-4 in 51; the absolute enhancement of liver parenchyma in patients with F0-1 was(24.6±8.8)HU, not significantly different compared to (25.2±5.6)HU in F2-4 (P>0.05), while the absolute enhancement value of aorta, fECV and hematokrit were (44.8±9.4)HU, (27.8±4.5)% and (40.8±5.2)%, significantly different compared to 【(40.6±7.2)HU,(37.5±4.8)% and (37.6±6.2)%, respectively, P<0.05】 in F2～4 group; the cut-off-value, the AUC (95% CI) , sensitivity, specificity and accuracy of fECV in diagnosing F2-4, F3-4 and F4 in patients with CHB were 30.2%, 0.71(0.59 to 0.84), 65.5%, 78.0% and 74.5%; 34.0%, 0.76(0.62 to 0.89), 75.8%, 74.2% and 75.0%; and 36.8%, 0.81(0.67 to 0.96), 90.5%, 72.6% and 86.8%. Conclusion The measurement of fECV by multi-phase dynamic CT scan might be applied as an effective noninvasive index for the diagnosis of HF in patients with CHB, which needs further investigation.

Key words: Hepatitis B, Hepatic fibrosis, Hepatic extracellular volume fractions, CT scan, Receiver operating characteristic curve, Diagnosis