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Quantification of Hemodynamic Changes in Chronic Liver Disease: Correlation of Perfusion-CT Data with Histopathologic Staging of Fibrosis.

Abstract：

RATIONALE AND OBJECTIVES:To noninvasively estimate the severity of liver fibrosis using perfusion-CT (PCT)-based quantification of dual liver blood supply prior to liver transplantation or liver resections and to correlate results with histological grading of fibrosis stages and AST-platelet ratio index. MATERIALS AND METHODS:Institutional review board approved this retrospective study. We analysed 41 consecutive patients (19 classified as Child-Pugh A, 17 as Child-Pugh B, and 5 as Child-Pugh C; MELD score ranged from 7 to 28) who underwent PCT prior to liver transplantation/liver resections between 2013 and 2016. The examination protocol included a scan time of 40 s, 80 kV, 100/120 mAs. Arterial liver perfusion, portal-venous perfusion and hepatic perfusion index (HPI) were registered in liver parenchyma by three readers. Fibrosis was histological graded according to Ishak scoring system as liver fibrosis (F3, n = 10), incomplete liver cirrhosis (F5, n = 5), and complete liver cirrhosis (F6, n = 26). RESULTS:Portal-venous perfusion was significantly higher in liver fibrosis (F3 69.5±23.7 ml/100 ml/min) compared to incomplete liver cirrhosis (F5, 52.9±25.7 ml/100 ml/min) and complete liver cirrhosis (F6, 46.4±24.8 ml/100 ml/min (range 6.3-112.0 ml/100 ml/min; F = 15, p < 0.0001). HPI showed the same group differences (F = 20, p < 0.0001; HPI F3: 19.1±10.7%, HPI F5: 38.5±24.3%, HPI F6: 43.4±25.8%). Group comparisons were not significant for arterial liver perfusion (F = 3, p = 0.15). PCT parameters as well as histological fibrosis grading did neither correlate with laboratory findings including AST-platelet ratio index and MELD-Score, nor with Child-Pugh-Score. CONCLUSION:Quantitative data from perfusion-CT can be used to differentiate between liver fibrosis (F3) and liver cirrhosis (F5/F6).

journal_name

Acad Radiol

journal_title

Academic radiology

authors

Wm T,L S,C K,K E,T H,H B,T K,K N,M H,S K

doi

10.1016/j.acra.2018.11.009

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1174-1180

issue

9

eissn

1076-6332

issn

1878-4046

pii

S1076-6332(18)30524-5

journal_volume

26

pub_type

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