CT perfusion at early stage of hepatic diffuse disease

Guan, Sheng; Zhao, Wei; Zhou, Kang; Peng, Wei; Mao, Jian; Tang, Feng

doi:10.3748/wjg.v11.i22.3465

Cited by 28 publications

(18 citation statements)

References 10 publications

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“…Guan et al [7] induced liver diffuse lesions in rats with diethylnitrosamine. They divided the processes of hepatic diffuse lesions into three stages of hepatitis, hepatic fibrosis, and cirrhosis.…”

Section: Perfusion Imaging Of Chronic Liver Diseasesmentioning

confidence: 99%

“…Fournier et al [14] induced primary hepatic carcinoma in a rat model by chemistry, and performed CTP after 11 and 18 wk, respectively, showing that the induced hepatic carcinoma has a high arterial blood flow and a low portal blood flow, with a sensitivity of 87% and a specificity of 80% at week 18, a sensitivity of 86% and a specificity of 65% at week [3] 0.19 1 0.93 2 Weidekamm et al [4] (24) 0.2 ± 0.08 1.02 ± 0.35 Zhou et al [5] (4) 0.17 ± 0.08 0.9 ± 0.04 16 ± 16% 106.24 ± 54.53 20.24 ± 8.26 15.06 ± 8.94 Hashimoto et al [6] (10) 18.4 ± 5.6% 103.9 ± 18 12.5 ± 2.0 11.1 ± 1. [7] Rat 14…”

Section: Primary Hepatic Carcinomamentioning

confidence: 99%

“…Previous studies used liver biopsy as gold standard to assess the degree of liver cirrhosis [6,7] . CTP can show pathological changes in the liver before cirrhosis, even at the early stage of fibrosis, and it can make non-invasive assessment of the degree of chronic liver disease (Table 2).…”

Section: Perfusion Imaging Of Chronic Liver Diseasesmentioning

confidence: 99%

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Clinical application of hepatic CT perfusion

Zhong¹,

Wang²,

Xu³

2009

WJG

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Section: Perfusion Imaging Of Chronic Liver Diseasesmentioning

confidence: 99%

Section: Primary Hepatic Carcinomamentioning

confidence: 99%

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Clinical application of hepatic CT perfusion

Zhong¹,

Wang²,

Xu³

2009

WJG

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“…Quantitative color mapping of the arterial enhancement fraction can be obtained from routine dynamic liver CT images (13). In cirrhotic liver parenchyma, the arterial enhancement fraction determined by quantitative mapping is increased with increasing severity of cirrhosis (9,14).…”

Section: Perfusion Imaging In Cirrhosismentioning

confidence: 99%

“…Perfusion parameters such as MTT and HPI correlate with the degree of hepatic dysfunction on the basis of clinical data in chronic liver disease (13,18) (Table 1). Perfusion CT imaging can be used to evaluate the hemo- dynamic changes in patients with liver cirrhosis.…”

Section: Perfusion Imaging In Cirrhosismentioning

confidence: 99%

Perfusion CT imaging of the liver: review of clinical applications

Oğul

Kantarcı²,

Genç³

et al. 2014

Diagn Interv Radiol

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Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemotherapy, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. The advent of multidetector CT has given rise to the acquisition of images with higher quality and accuracy. Multidetector CT has been developed as a noninvasive imaging modality for evaluation of vascular anatomy. It has also made it possible to perform CT angiography of the hepatic vessels. New generation CT systems with multidetector are capable of performing volumetric imaging. These systems provide a single rotational acquisition and almost the whole upper abdomen can be appraised by means of serial rotational acquisitions at a single location in the z-direction. Multidetector CT imaging is used extensively for the preoperative selection of living related liver donors, as well as evaluation of the vascular anatomy of the recipients (1). This imaging technique is also used for the initial evaluation and follow-up of most patients with hepatic metastases, providing valuable information about the number, size, and distribution of hepatic metastases and the presence and extent of extrahepatic disease (1).Perfusion CT imaging permits the qualitative and quantitative assessment of liver perfusion. In perfusion CT, a quantitative tissue perfusion map is obtained from dynamic CT data and displayed using a color scale permitting the quantification of tissue perfusion in absolute units at high spatial resolution (2). Perfusion CT efficiently locates abnormal tissue perfusion which is difficult to detect accurately with conventional CT (3). Functional assessment of the perfusion of normal and pathologic tissues is performed by means of quantitative or semiquantitative parameters, such as blood flow (BF), blood volume (BV), mean transit time (MTT), portal liver perfusion (PLP), arterial liver perfusion (ALP) and hepatic perfusion index (HPI). Perfusion CT measures the temporal changes in tissue density through a series of dynamically acquired CT images after intravenous injection of an iodinated contrast material (4, 5). Perfusion CT may be performed quickly and provide valuable data for diagnosis. However, there are some limitations of this method such as long breath-holding for portal flow measurement, separation of arterial and portal blood flow, additional radiation exposure, limited craniocaudal scan range, and standardization of analytic methods (2). In this a...

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Characterization of hepatocellular carcinoma and colorectal liver metastasis by means of perfusion MRI

Abdullah

Pialat

Wiart

et al. 2008

Magnetic Resonance Imaging

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Purpose: To characterize and compare hepatocellular carcinoma and liver metastases of colorectal metastatic cancer (CMC) by means of quantitative liver perfusion MRI. Materials and Methods:Liver perfusion was assessed in 26 HCC and CMC patients (50 nodules) by means of contrast-enhanced MRI. Six perfusion parameters-hepatic perfusion index (HPI), mean transit time (MTT), distribution volume (DV), total blood flow (F T ), arterial blood flow (F A ), and portal blood flow (F P )-were calculated in tumor nodules and the adjacent hepatic parenchyma. Results:The values of F T , F A , F P , and DV were significantly higher in the HCC than in the CMC group, whereas MTT was significantly higher in the CMC group. There was no significant difference in HPI. Arterial blood flow was higher than portal blood flow in the CMC group, while portal blood flow was slightly higher than arterial blood flow in the HCC group. Conclusion:The present work describes the use of dynamic MRI to quantitatively assess liver perfusion, which in the future may help studying liver cancers on the basis of their microvascular characteristics. BLOOD REACHES THE LIVER by two pathways: first, by the hepatic artery, which carries between 25% and 30% of the total hepatic blood flow; and second, by the portal vein carrying between 70% and 75%.The proportion between hepatic artery and portal perfusion varies according to the pathologic status of the liver. Liver cancers differ in their type of vascularization. In general, hepatocellular carcinoma (HCC), the most frequent primary malignant liver tumor (1), is hypervascular and vascularized initially by the hepatic artery. In contrast, colorectal metastatic cancer (CMC) is hypovascular. Also, the vascular architecture of the intra-cancerous mass differs from that of the surrounding liver parenchyma according to the size and differentiation grade: the cancer mass is fed by both the portal vein and the hepatic artery in the early stages, while the hepatic artery is the only source for end-stage HCC and CMC (2-9). In clinical practice, the ability to quantitatively assess liver perfusion parameters has considerable potential (10). Indeed, quantification of hepatic and portal blood flow may prove useful to study liver cancer and metastases and to assess delivery of drugs in health and diseases. For example, obtaining information about the degree of the arterial and portal contribution in the tumors vascularization may play a role in determining when to use some kinds of therapy like arterial chemoembolization and antiangiogenic therapy. Time-intensity curve analysis of MR imaging of the liver after contrast agent injection enables perfusion parameters to be estimated (11)(12)(13)(14). The aim of the present prospective study was to noninvasively quantify the differences in liver perfusion in the two most frequent groups of liver cancer, i.e., HCC and CMC, using firstpass dynamic MRI. To the best of our knowledge, this is the first quantitative comparison of perfusion parameters in these cancers to use multisli...

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CT perfusion at early stage of hepatic diffuse disease

Abstract: The technique could reflect some early changes of hepatic blood perfusion in rat with liver diffuse disease and is valuable for their early diagnosis.

Cited by 28 publications

References 10 publications

Clinical application of hepatic CT perfusion

Clinical application of hepatic CT perfusion

Perfusion CT imaging of the liver: review of clinical applications

Characterization of hepatocellular carcinoma and colorectal liver metastasis by means of perfusion MRI

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