Three-dimensional image analysis of hepatic restructuring in liver cirrhosis

OBJECTIVE: To investigate the three-dimensional structure, including the angioarchitecture, of the cirrhotic liver and clarify morphogenesis of the cirrhotic nodule. STUDY DESIGN: The three-dimensional liver structure of nontumor areas in two partially hepatectomized cases of hepatitis C virus-positive liver cirrhosis with hepatocellular carcinoma was examined by computerized reconstruction from serial tissue sections. RESULTS: Our image analysis revealed the following: (1) The parenchyma consisted of two kinds of cirrhotic nodules. The first was the nodule centrifugally formed around the portal veins, and their flows drained into the hepatic veins inside and around the nodule. The second was the nodule derived from the first. The latter was divided into the former by bridging fibrosis-induced intranodular septation. (2) The stroma consisted of the newly formed fibrovascular tissue--i.e., the septum and intranodular inflow and outflow vascular systems and the preexisting one. CONCLUSION: Our computerized reconstruction suggested, from an angioarchitectural point of view, that the first and second kind of cirrhotic nodule might be named the stable and the unstable nodule, respectively, and that the first kind of cirrhotic nodule could be derived from the regenerative nodule appearing in the course of chronic hepatitis.