Role of dual-source CT low-dose whole liver perfusion imaging in evaluating liver blood perfusion after transjugular intrahepatic portosystemic shunt in cirrhotic patients with portal hypertension

• Main Authors: ZHAI Yanan, LI lei, YIN Liang
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2016-10-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=7740

Objective To investigate the role of dual-source CT low-dose whole liver perfusion imaging in evaluating the hemodynamic changes in liver parenchyma before and after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients with portal hypertension. Methods A total of 52 cirrhosis patients with portal hypertension underwent whole liver perfusion CT scan 2 days before TIPS and at 1 week after TIPS. The image quality was evaluated and a post-processing workstation was used to observe the changes in perfusion parameters. Paired t-test was applied for comparison between two groups, and pearson linear correlation was applied for correlation analysis. Results Hepatic arterial perfusion(HAP) increased from 19.85 ml/(min·100 ml)±9.48 ml/(min·100 ml) before TIPS to 29.36 ml/(min·100 ml)±13.65 ml/(min·100 ml) after TIPS (t=-6.161, P=0.003), and the hepatic arterial perfusion index(HPI) increased from 54.32%±19.60% before TIPS to 64.11%±11.19% after TIPS (t=-6.202, P=0.029). Portal vein perfusion(PVP) was reduced from 19.75 ml/(min·100 ml)±10.60 ml/(min·100 ml) before TIPS to 16.13 ml/(min·100 ml)±8.60 ml/(min·100 ml) after TIPS, and total liver perfusion (TLP) increased from 36.14 ml/(min·100 ml)±16.61 ml/(min·100 ml) before TIPS to 44.12 ml/(min·100 ml)±14.60 ml/(min·100 ml) after TIPS (both P＞0.05). The mean effective radiation dose of whole liver perfusion scan was 16.5 mSv. PVP, TLP, and HPI were significantly correlated with the injection rate of contrast agent(r=0.992,P=0.001;r=-0.903,P=0.036;r=-0.899，P=0.038). HAP, PVP, and TLP were negatively correlated with the sample size(r=-0.922,P=0.026;r=-0.943,P=0.016;r=-0.998,P＜0.001). TLP was positively correlated with the voltage of X-ray tube and scantimes(r=0.896, P=0.039;r=0.907,P=0.033). Conclusion Dual-source CT low-dose whole liver perfusion can be used to observe the hemodynamic changes in cirrhotic patients with portal hypertension before and after TIPS and provide a reference for preoperative evaluation and therapeutic effect evaluation.