TC PERFUSIÓN CUANTITATIVA NO INVASIVA DEL HÍGADO EN LA HEPATITIS AUTOINMUNE

Computed tomography (CT) perfusion provides a non-invasive approach to assessing hemodynamic alterations in chronic liver diseases. While its usefulness has been demonstrated in viral hepatitis, evidence regarding autoimmune hepatitis (AIH) remains limited. This study aimed to compare CT perfusion parameters - arterial flow (AF), portal flow (PF), and perfusion index (PI) - in patients with AIH - related fibrosis and cirrhosis versus healthy controls (potential liver donors).

In this single-center prospective study, 21 patients with AIH-related fibrosis and 17 patients with AIH-related cirrhosis were compared with 20 potential living liver donors, i.e. the control group. CT perfusion parameters, including AF, PF and PI were calculated.

Histological staging identified fibrosis stages (F1-F3 stage fibrosis) in 21 patients and cirrhosis (F4) in 17 patients. Inflammatory activity grades ranged from A1 to A4. AF was significantly elevated in both AIH-fibrosis (p<0.001) and AIH-cirrhosis (p=0.001) compared with the control group, but did not differ significantly between fibrosis and cirrhosis (p=0.294). PF was significantly reduced in AIH-fibrosis (p=0.001) and AIH-cirrhosis (p<0.001) compared with controls, with no significant difference between fibrosis and cirrhosis (p=0.084). Both AF and PF demonstrated high sensitivity (95%) in differentiating patients for both AIH-related fibrosis and cirrhosis from the control group.

Increased AF and reduced PF, already evident at the fibrosis stage, may serve as non-invasive markers of AIH-related liver injury severity.