[Hepatic perfusion changes after interventional disconnection evaluated by CT perfusion imaging]

Area of Science:

• Radiology and Medical Imaging
• Hepatology
• Interventional Radiology

Background:

• Cirrhosis and portal hypertension significantly alter hepatic hemodynamics.
• Interventional procedures aim to manage complications of portal hypertension.
• Accurate assessment of hepatic perfusion is crucial for treatment evaluation.

Purpose of the Study:

• To evaluate changes in hepatic perfusion using spiral CT perfusion imaging.
• To assess the impact of interventional obliteration on liver blood flow in patients with cirrhosis and portal hypertension.

Main Methods:

• Twenty-three patients with cirrhosis and portal hypertension underwent interventional procedures (Partial Splenic Embolization or PSE + Percutaneous Transhepatic Obliteration or PTO).
• Hepatic perfusion was assessed using spiral CT perfusion imaging pre- and post-intervention.
• Key perfusion parameters were calculated from density-time curves of the liver, abdominal artery, and portal vein.

Main Results:

• Partial Splenic Embolization (PSE) led to decreased portal vein perfusion (PVP) without significant changes in total hepatic blood perfusion.
• Patients undergoing PSE combined with Percutaneous Transhepatic Obliteration (PTO) showed a significant increase in hepatic artery perfusion and total hepatic blood perfusion post-treatment.
• PVP decreased post-intervention, but this change was not statistically significant in the PSE group.

Conclusions:

• Spiral CT perfusion imaging provides objective assessment of hemodynamic changes in the liver parenchyma.
• Interventional vascular obliteration techniques can alter hepatic perfusion patterns in patients with cirrhosis and portal hypertension.