CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertensionReportar como inadecuado




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European Radiology

pp 1–8

First Online: 20 March 2017Received: 31 October 2016Revised: 12 January 2017Accepted: 23 February 2017

Abstract

ObjectivesTo correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient HVPG measurements in patients with cirrhosis.

MethodsTwenty-one patients with cirrhosis males, 17; females, 4; mean ± SD age, 57 ± 7 years underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms maximum slope analysis and Patlak plot were used to measure hepatic arterial flow HAF, portal venous flow PVF, hepatic perfusion index HPI, splenic arterial flow SAF, splenic blood volume SBV and splenic clearance SCL. Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension ≥12 mmHg were calculated.

ResultsThe Spearman correlation coefficient was −0.53 p < 0.05 between SAF and HVPG, and −0.68 p < 0.01 between HVPG and SCL. Using a cut-off value of 125 ml-min-100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG.

ConclusionCT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension.

Key points• SAF and SCL are statistically significantly correlated with HVPG

• SCL showed stronger correlation with HVPG than SAF

• 125 ml-min-100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH

• HAF, PVF and HPI showed no statistically significant correlation with HVPG

KeywordsCT-perfusion Liver Spleen Cirrhosis Portal hypertension Abbreviations and acronymsHAFHepatic arterial flow ml-min-100 ml

HPIHepatic perfusion index %

HVPGHepatic venous pressure gradient mmHg

PHPortal hypertension

PVFPortal venous flow ml-min-100 ml

SAFSplenic arterial flow ml-min-100 ml

SBVSplenic blood volume ml-100 ml

SCLSplenic clearance ml-min-100 ml

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Autor: Emina Talakić - Silvia Schaffellner - Daniela Kniepeiss - Helmut Mueller - Rudolf Stauber - Franz Quehenberger - Helmut Sc

Fuente: https://link.springer.com/







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