Quantification of Hemodynamic Changes in Chronic Liver Disease: Correlation of Perfusion-CT Data with Histopathologic Staging of Fibrosis

Wm, Thaiss; Sannwald, Lennart W.; Kloth, C; Ekert, Kaspar; Hepp, Tobias; Bösmüller, Hans; Klag, Thomas; Nikolaou, Konstantin; Horger, Marius; Kaufmann, Sascha

doi:10.1016/j.acra.2018.11.009

Cited by 13 publications

(6 citation statements)

References 25 publications

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“…It is also highly probable that IVIM measures do not necessarily agree with histopathological grading at one-to-one individual patients' level. This point has been suggested by previous CT perfusion studies (8,26,27). Thaiss et al (26) reported portal-venous perfusion measured by CT was higher in liver fibrosis than in complete liver cirrhosis; however, they did not found correlation between perfusion CT parameters and Child-Pugh score or the clinical laboratory values.…”

Section: Discussionmentioning

confidence: 59%

“…This point has been suggested by previous CT perfusion studies (8,26,27). Thaiss et al (26) reported portal-venous perfusion measured by CT was higher in liver fibrosis than in complete liver cirrhosis; however, they did not found correlation between perfusion CT parameters and Child-Pugh score or the clinical laboratory values. With perfusion CT, Ronot et al (27) demonstrated that, compared with those with minimal fibrosis (F1), patients with intermediate fibrosis (F2 and F3) had decreased portal venous perfusion and total liver perfusion, while the mean transit time increased.…”

Section: Discussionmentioning

confidence: 59%

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Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis

Li¹,

Che-Nordin²,

Wáng³

et al. 2019

Quant. Imaging Med. Surg

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Background: Recent two studies reported that intravoxel incoherent motion (IVIM) analysis can separate healthy livers and viral hepatitis B (VHB) induced liver fibrosis. However, in these two studies the starting b value for bi-exponential decay analysis was b =10 and 15 s/mm 2 respectively. The current study has two primary aims. The first is to further confirm the diagnostic value of IVIM in detecting liver fibrosis. The second is to test whether by sampling very low b value densely, then b =0 s/mm 2 image could be included to improve IVIM's diagnostic performance.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 59%

Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis

Li¹,

Che-Nordin²,

Wáng³

et al. 2019

Quant. Imaging Med. Surg

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“…Reduced liver perfusion in chronic liver disease has already been investigated by other groups [19,20]. As the portal venous perfusion decreases, the arterial perfusion fraction increases, and total liver perfusion is delayed in patients with higher degrees of fibrosis [21]. Zissen et al reported a significant decrease in the liver-to-aorta ratio in LSVAR cutoff of 0.42 or higher provides a sensitivity of 92% and a specificity of 70%.…”

Section: Discussionmentioning

confidence: 98%

“…Reduced liver perfusion in chronic liver disease has already been investigated by other groups [ 19 , 20 ]. As the portal venous perfusion decreases, the arterial perfusion fraction increases, and total liver perfusion is delayed in patients with higher degrees of fibrosis [ 21 ]. Zissen et al reported a significant decrease in the liver-to-aorta ratio in cirrhotic patients compared with patients without CLD [ 22 ], while Koiwahara et al demonstrated a decreasing parenchymal density (ΔHU precontrast to portal venous phase) in patients with higher degrees of chronic liver damage [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)

et al. 2020

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Background The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR). Material and methods Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis. Results The LSVR and LSVAR allowed significant differentiation between patients with (n = 19) and without (n = 122) significantly elevated liver stiffness (p < 0.001). However, the LSVAR showed a higher area under the curve (AUC = 0.96) than the LSVR (AUC = 0.74). The optimal cutoff value was 0.34 for the LSVR, which detected clinically increased liver stiffness with a sensitivity of 53% and a specificity of 88%. With a cutoff value of 0.67 for the LSVAR, the sensitivity increased to 95% while maintaining a specificity of 89%. Conclusion The LSVAR improves the detection of significant liver fibrosis on portal venous CT scans compared to the LSVR.

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“…Computed tomographic (CT) perfusion imaging is well documented as a valid quantitative method for identifying liver hemodynamic properties in several hepatic entities, and it has already been clinically applied (6)(7)(8)(9)(10). The CT perfusion imaging procedure can compensate for the limitations in the use of ultrasound, which reveals only blood velocity.…”

mentioning

confidence: 99%

Hemodynamic Alteration in the Liver in Acute Hepatitis: A Quantitative Evaluation Using Computed Tomographic Perfusion

Nishie

Ushijima

Takayama

et al. 2021

In Vivo

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Background/Aim: We aimed to elucidate the hemodynamic alterations in the liver of patients with acute hepatitis (AH) using computed tomography perfusion imaging. Patients and Methods: For 14 patients with AH and nine patients with no disease (ND group), we compared the mean arterial blood flow (AF), portal blood flow (PF) and perfusion index (%) [PI=AF/(AF+PF) ×100] of the right and left liver lobes and investigated their relationship with clinical factors. Results: The mean PI of the right lobe in the AH group (30.5±10.0%) was significantly higher than that in the ND group (20.8±9.7%) (p=0.031). For all patients of the AH and ND groups, the PI of the right lobe was increased as the prothrombin time decreased (R=-0.56, p=0.006) and as the prothrombin time-international normalized ratio increased (R=0.48, p=0.02). Conclusion: The PI of the right liver lobe may increase in AH and may be a predictive parameter for the severity of hepatic failure.

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Quantification of Hemodynamic Changes in Chronic Liver Disease: Correlation of Perfusion-CT Data with Histopathologic Staging of Fibrosis

Cited by 13 publications

References 25 publications

Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis

Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis

Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)

Hemodynamic Alteration in the Liver in Acute Hepatitis: A Quantitative Evaluation Using Computed Tomographic Perfusion

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