Quantification of Hemodynamic Changes in Chronic Liver Disease: Correlation of Perfusion-CT Data with Histopathologic Staging of Fibrosis
| Autor: | Wolfgang M. Thaiss, Sascha Kaufmann, Marius Horger, Hepp T, Hans Bösmüller, L Sannwald, Konstantin Nikolaou, C. Kloth, Thomas Klag, Kaspar Ekert |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Perfusion Imaging medicine.medical_treatment Hemodynamics Liver transplantation Chronic liver disease Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences Hepatic Artery 0302 clinical medicine Fibrosis Internal medicine medicine Hepatectomy Humans Radiology Nuclear Medicine and imaging Aspartate Aminotransferases Grading (tumors) Aged Retrospective Studies Aged 80 and over Platelet Count Portal Vein business.industry Retrospective cohort study Middle Aged medicine.disease Liver Transplantation 030220 oncology & carcinogenesis Female Tomography X-Ray Computed business Perfusion |
| Zdroj: | Academic Radiology. 26:1174-1180 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2018.11.009 |
| Popis: | 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.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).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, p0.0001). HPI showed the same group differences (F = 20, p0.0001; 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.Quantitative data from perfusion-CT can be used to differentiate between liver fibrosis (F3) and liver cirrhosis (F5/F6). |
| Databáze: | OpenAIRE |
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