Quantitative hepatic CT perfusion measurement: Comparison of Couinaud's hepatic segments with dual-source 128-slice CT

Wang, Xuan; Xue, Huadan; Jin, Zhengyu; Su, Binbin; Li, Zhuo; Sun, Hao; Chen, Yu; Liu, Wei

doi:10.1016/j.ejrad.2012.09.015

Cited by 23 publications

(19 citation statements)

References 18 publications

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“…single-source 64-slice CT with a scan range of 6.7 cm as well as a dualsource 128-slice CT with a scan range of 14.8 cm; using the latter technique, 98% of all hepatic metastases were successfully imaged in their patients. 38 Others have also demonstrated the utility of periodic spiral CT 40,41 and have shown that a periodic spiral scan mode is equivalent to a standard dynamic mode for quantitative evaluation of tissue flow. 42 Thus, our findings regarding the utility of perfusion parameters such as rPVF for the preoperative diagnosis of mVI in sHCC may be applicable to other methodologies that extend the zaxis coverage to permit scanning of the majority of the liver.…”

Section: Figurementioning

confidence: 97%

Liver Computed Tomographic Perfusion in the Assessment of Microvascular Invasion in Patients With Small Hepatocellular Carcinoma

Wu¹,

Tan²,

Zhou³

et al. 2015

Investigative Radiology

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Section: Figurementioning

confidence: 97%

Liver Computed Tomographic Perfusion in the Assessment of Microvascular Invasion in Patients With Small Hepatocellular Carcinoma

Wu¹,

Tan²,

Zhou³

et al. 2015

Investigative Radiology

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“…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.…”

mentioning

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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“…Likewise, on a macroscopic level, the arterial blood supply is not homogenously distributed over the various liver segments. It has been reported that the ratio of the arterial liver perfusion (ALP) and portal venous perfusion (PVP) varies and is the lowest in segments V to VIII and highest in segments I to IV [38,39]. When the ALP over-compensates the PVP in Fontan patients, it is expected that the microperfusion increases in segments I to IV, and diminishes in segments V to VIII.…”

Section: Discussionmentioning

confidence: 99%

Diminished liver microperfusion in Fontan patients: A biexponential DWI study

et al. 2017

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It has been demonstrated that hepatic apparent diffusion coefficients (ADC) are decreasing in patients with a Fontan circulation. It remains however unclear whether this is a true decrease of molecular diffusion, or rather reflects decreased microperfusion due to decreased portal blood flow. The purpose of this study was therefore to differentiate diffusion and microperfusion using intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) for different liver segments in patients with a Fontan circulation, compare to a control group, and relate with liver function, chronic hepatic congestion and hepatic disease. For that purpose, livers of 59 consecutively included patients with Fontan circulation (29 men; mean-age, 19.1 years) were examined (Oct 2012─Dec 2013) with 1.5T MRI and DWI (b = 0,50,100,250,500,750,1500,1750 s/mm2). IVIM (Dslow, Dfast, ffast) and ADC were calculated for eight liver segments, compared to a control group (19 volunteers; 10 men; mean-age, 32.9 years), and correlated to follow-up duration, clinical variables, and laboratory measurements associated with liver function. The results demonstrated that microperfusion was reduced (p<0.001) in Fontan livers compared to controls with ─38.1% for Dfast and ─32.6% for ffast. Molecular diffusion (Dslow) was similar between patients and controls, while ADC was significantly lower (─14.3%) in patients (p<0.001). ADC decreased significantly with follow-up duration after Fontan operation (r = ─0.657). Dslow showed significant inverse correlations (r = ─0.591) with follow-up duration whereas Dfast and ffast did not. From these results it was concluded that the decreasing ADC values in Fontan livers compared with controls reflect decreases in hepatic microperfusion rather than any change in molecular diffusion. However, with the time elapsed since the Fontan operation molecular diffusion and ADC decreased while microperfusion remained stable. This indicates that after Fontan operation initial blood flow effects on the liver are followed by intracellular changes preceding the formation of fibrosis and cirrhosis.

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Quantitative hepatic CT perfusion measurement: Comparison of Couinaud's hepatic segments with dual-source 128-slice CT

Cited by 23 publications

References 18 publications

Liver Computed Tomographic Perfusion in the Assessment of Microvascular Invasion in Patients With Small Hepatocellular Carcinoma

Liver Computed Tomographic Perfusion in the Assessment of Microvascular Invasion in Patients With Small Hepatocellular Carcinoma

Perfusion CT imaging of the liver: review of clinical applications

Diminished liver microperfusion in Fontan patients: A biexponential DWI study

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