Hemodynamic study on liver cirrhosis: clinical application of CT perfusion imaging

Objective To estimate hepatic perfusion parameters with helical CT, and to study the relationship between hepatic perfusion parameters and the severity of liver cirrhosis.Methods Dynamic single-section computed tomography (CT) of the liver was performed in 40 participants, including (27 patients) with liver cirrhosis and 13 patients without liver disease (control subjects). CT scans were obtained at a single level to include the liver, spleen, aorta, and portal vein. On each CT scan, the attenuation of these organs was measured in regions of interest to provide time-density curves. The arterial, portal venous, and total perfusion of the liver and the hepatic perfusion index were assessed.Results In the control group, hepatic arterial perfusion, portal venous perfusion, and total hepatic perfusion were (0.2823±0.0969) ml·min~(-1)·ml~(-1), (1.1788±0.4004) ml·min~(-1)·ml~(-1), and (1.4563±0.4439) (ml·min~(-1)·ml~(-1)), respectively. Hepatic perfusion index was (19.73±5.81)%. These hepatic perfusion parameters correlated significantly with the severity of liver cirrhosis. Hepatic arterial perfusion decreased in Child A and B cirrhotic patients [(0.1685±0.1068) ml·min~(-1)·ml~(-1) and (0.1921±0.0986) ml·min~(-1)·ml~(-1), respectively]. Comparing to Child A and B cirrhotic patients, hepatic arterial perfusion in Child C cirrhotic patients [(0.3072±0.1145) ml·min~(-1)·ml~(-1)] raised significantly. Portal venous perfusion decreased significantly in Child B and C cirrhotic patients [(0.6331±0.2070) ml·min~(-1)·ml~(-1) and (0.5702±0.3562) ml·min~(-1)·ml~(-1), respectively]. Total hepatic blood flow reduced markedly in Child B and C cirrhotic patients [(0.8252±0.2952) ml·min~(-1)·ml~(-1) and (0.8774±0.4118) ml·min~(-1)·ml~(-1), respectively]. Hepatic perfusion index increased in Child C cirrhotic patients (37.48±16.65)%.Conclusion Dynamic single-section CT showed potential in quantifying hepatic perfusion parameters, and hepatic perfusion parameters measured with CT were significantly altered in cirrhosis and correlated with the severity of liver cirrhosis.