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[Hepatic perfusion changes after interventional disconnection evaluated by CT perfusion imaging]
Jia-Ping Li1, Wei Chen, Yong-Hui Huang
1Department of Interventional Radiology, the First Affiliated Hospital of Sun Yat-sen University of Medical Sciences, Guangzhou 510080, China.
Insights
Spiral CT perfusion imaging effectively tracks liver blood flow changes after interventional obliteration for cirrhosis and portal hypertension, showing increased hepatic artery perfusion post-treatment.
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.
Objective:
To evaluate the changes in hepatic perfusion after interventional obliteration in patients with cirrhosis and portal hypertension by means of spiral CT perfusion imaging.
Methods:
Twenty-three patients who suffered from cirrhosis and portal hypertension were selected to undergo interventional disconnection. Partial spleen embolization (PSE) was performed in 15 patients and PSE combined with percutaneous transhepatic obliteration (PTO) was carried out in 8 patients. Hepatic perfusion was carried out pre- and post-operation. The density-time curve was obtained from the interest region of liver, abdominal artery, portal vein. The parameters of perfusion were calculated by the means of deconvolution simultaneously.
Results:
The portal vein perfusion (PVP) decreased in patients with PSE, but total hepatic blood perfusion was not statistically different from that of pre-operation. After treatment, the hepatic artery perfusion increased obviously. PVP decreased from 0.862 to 0.722 ml x min(-1) x ml(-1) but was not statistically different from that of pre-operation. Hepatic arterial perfusion and total hepatic blood perfusion increased from 0.128, 0.990 ml x min(-1)x ml(-1) pre-operatively to 0.290, 1.021 ml x min(-1) x ml(-1) postoperatively in patients with PSE combined with PTO.
Conclusions:
Spiral CT perfusion could objectively reflect the hemodynamic change in hepatic parenchyma after the interventional vascular obliteration.
