Analysis of Quantitative Data of Arterial Spin Labeling Perfusion of the Liver at Admission and Follow up of Patients with Viral Cirrhosis

Abstract

The aim of this work is to analyze quantitative data of magnetic resonance ASL-perfusion of the liver at admission and follow up of patients with viral cirrhosis.The study included 34 patients with viral liver cirrhosis: 23 (67.6 %) men and 11 (32.4 %) women. All subjects underwent abdominal ultrasound with Dopplerography of the abdominal vessels, shear wave elastography, Arterial spin Labeling (ASL) — Perfusion of the liver by magnetic resonance imaging. Post-processing of ASL-perfusion images was carried out, their quantitative assessment in regenerative liver nodules and the parenchyma structure was carried out. It was found that for patients with liver cirrhosis according to Child-Pugh Class A, regardless of the degree of activity, the values of ASL-perfusion of the liver were 99.6 ± 1.8 ml/100g/min, with class B — 95.6 ± 4.9 ml/100g/min, with class C — 98.5 ± 2.6 ml/100g/min. To determine the diagnostic significance of liver ASL-perfusion, a generalized prognosis ratio ΔM = MNBF/ MHBF was calculated, where MNBF is a quantitative indicator of volumetric blood flow in the regenerative nodule, MHBF is a quantitative indicator of volumetric hepatic blood flow in the surrounding parenchyma. The results obtained by ASL-perfusion were compared with the data of shear wave elastography.For patients with viral liver cirrhosis the quantitative indicator of ASL-perfusion of the liver is less than 101.4 ml/100g/min. To predict the course of viral etiology cirrhosis, the prognosis ratio ΔM should be taken, and if ΔM > 1, this indicates a poor prognosis (fibrosis progression), if ΔM ≤ 1 — a favorable one (no fibrosis progression). Diagnostic and prognostic significance of ASL-liver perfusion for patients with viral cirrhosis at admission to the hospital — AUROC = 0.865 (95 % CI 0.843–0.928) and follow up — AUROC = 0.915 (95 % CI 0.881–0.946).