Xenon computed tomography can evaluate the improvement of hepatic hemodynamics before and after endoscopic injection sclerotherapy

Takahashi, Hideaki; Suzuki, Michihiro; Shigefuku, Ryuta; Okano, Miki; Hiraishi, Tetsuya; Takagi, Ryuichi; Noguchi, Yoshiko; Hattori, Nobuhiro; Hatsugai, Moriaki; Nakahara, Kazunari; Okamoto, Masaaki; Kobayashi, Minoru; Ikeda, Hiroki; Fukuda, Yasunobu; Nagase, Yoshihiko; Ishii, Toshimasa; Matsunaga, Kotaro; Matsumoto, Nobuyuki; Okuse, Chiaki; Sase, Sadanori; Itoh, Fumio

doi:10.1007/s00535-013-0756-7

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…However, it is an indirect assessment and lower specificity may be the disadvantage. Xenon CT shows quantitative assessment of hepatic tissue blood flow as well as arterial/portal venous flow (90). Fourdimensional flow MRI is also available to evaluate portal hemodynamics by using volumetric acquisition technique (91)(92)(93).…”

Section: Summary Of Imaging Techniques For the Evaluation Of Portal System And Collateralsmentioning

confidence: 99%

Collaterals in portal hypertension: anatomy and clinical relevance

Maruyama¹,

Shiina²

2021

Quant Imaging Med Surg

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Portal hypertension is a key pathophysiology of chronic liver diseases typified with cirrhosis or noncirrhotic portal hypertension. The development of collateral vessels is a characteristic feature of impaired portal hemodynamics. The paraumbilical vein (PUV), left gastric vein (LGV), posterior gastric vein (PGV), short gastric vein (SGV), splenorenal shunt (SRS), and inferior mesenteric vein (IMV) are major collaterals, and there are some rare collaterals. The degree and hemodynamics of collateral may affect the portal venous circulation and may compensate for the balance between inflow and outflow volume of the liver. Additionally, the development of collateral shows a relation with the liver function reserve and clinical manifestations such as esophageal varices (EV), gastric varices, rectal varices and the other ectopic varices, hepatic encephalopathy, and prognosis. Furthermore, there may be an interrelationship in the development between different collaterals, showing additional influences on the clinical presentations. Thus, the assessment of collaterals may enhance the understanding of the underlying pathophysiology of the condition of patients with portal hypertension. This review article concluded that each collateral has a specific function depending on the anatomy and hemodynamics and is linked with the relative clinical presentation in patients with portal hypertension. Imaging modalities may be essential for the detection, grading and evaluation of the role of collaterals and may help to understand the pathophysiology of the patient condition. Further investigation in a large-scale study would elucidate the basic and clinical significance of collaterals in patients with portal hypertension and may provide information on how to manage them to improve the prognosis as well as quality of life.

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Section: Summary Of Imaging Techniques For the Evaluation Of Portal System And Collateralsmentioning

confidence: 99%

Collaterals in portal hypertension: anatomy and clinical relevance

Maruyama¹,

Shiina²

2021

Quant Imaging Med Surg

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“…Moreover, in patients with liver cirrhosis, we previously reported that hepatic TBF varied according to the etiology of the disease [18–20]. However, no studies have compared the TBF between NAFLD and CH-C in detail.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Hepatic Tissue Blood Flow Using Xenon Computed Tomography with Fibrosis Progression in Nonalcoholic Fatty Liver Disease: Comparison with Chronic Hepatitis C

Shigefuku

Takahashi

Kato

et al. 2014

IJMS

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AimsThe present study evaluated the utility of xenon computed tomography (Xe-CT) as a noninvasive diagnostic procedure for the measurement of hepatic tissue blood flow (TBF) in patients with nonalcoholic fatty liver disease (NAFLD) or chronic hepatitis C (CH-C).MethodsXe-CT was performed in 93 patients with NAFLD and in 109 patients with CH-C. Subjects were classified into one of three groups, based on fibrosis stage: group 1, no bridging fibrosis; group 2, bridging fibrosis; and group 3, liver cirrhosis. Correlations between hepatic TBFs in each fibrosis stage were examined.ResultsIn group 1, portal venous TBF (PVTBF), hepatic arterial (HATBF), and total hepatic TBF (THTBF) were significantly lower in patients with in nonalcoholic steatohepatitis (NASH) than in those with CH-C (p < 0.001, p < 0.05, p < 0.001, respectively). In group 2, PVTBF and THTBF were significantly lower in patients with in NASH than in those with CH-C (p < 0.001, p < 0.05, respectively). In group 3, hepatic TBFs were not significantly different when comparing patients with NASH and those with CH-C.ConclusionsPVTBF decreased due to fat infiltration. Therefore, hemodynamic changes occur relatively earlier in NAFLD than in CH-C. Patients with NASH should be monitored carefully for portal hypertensive complications in the early fibrosis stage.

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“…The portal flow increased after EIS in some cases; however, in some cases it did not increase after EIS. In this study, we elucidated the characteristics of cases without increased portal flow after EIS by evaluating the portal hemodynamics before and after EIS [7]. The PVTBF increased in 66% cases following EIS.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported on changes in portal hemodynamics using Doppler ultrasonography (US) before and after EIS [4][5][6]. The portal tissue blood flow (PVTBF) using xenon computed tomography (Xe-CT) increases after the obliteration of EGV by EIS [7]. However, it is not always possible to increase PVBTF following the obliteration of varices.…”

Section: Introductionmentioning

confidence: 99%

Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function

et al. 2022

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Objectives To identify patients suitable for endoscopic injection sclerotherapy (EIS) by evaluating their portal hemodynamics and liver function. Methods We selected 58 patients with esophagogastric varices (EGV) and liver cirrhosis (LC) related to either hepatitis C virus (C) (n = 19), hepatitis B virus (n = 2), alcohol (AL) (n = 20), C + AL (n = 6), non-alcoholic steatohepatitis (n = 6), others (n = 3), or non-LC (n = 2). All patients underwent EIS. We measured their portal venous tissue blood flow (PVTBF) and hepatic arterial tissue blood flow (HATBF) using xenon computed tomography before and after EIS. We classified them into increased group and decreased group according to the PVTBF to identify the predictors that contribute to PVTBF increase post-EIS. Results Low value of indocyanine green retention at 15 min (ICG-R15), the absence of paraesophageal veins, and low baseline PVTBF/HATBF (P/A) ratio predicted increased PVTBF in the multivariate logistic analysis (odds ratio (OR) 10.46, p = 0.0391; OR 12.45, p = 0.0088; OR 13.57, p = 0.0073). The protein synthetic ability improved 1 year post-EIS in increased group. Cox proportional hazards regression identified alcohol drinking (hazard ratio; 3.67, p = 0.0261) as an independent predictor of EGV recurrence. Conclusions Patients with low ICG-R15, low P/A ratio, and the absence of paraesophageal veins were probable predictors of PVTBF improvement post-EIS. In addition, the improvement of hepatic hemodynamics likely enhanced liver function following EIS.

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Xenon computed tomography can evaluate the improvement of hepatic hemodynamics before and after endoscopic injection sclerotherapy

Abstract: Xenon computed tomography showed that PVTBF increased after EIS for EGV and HATBF decreased in response to an increase in PVTBF.

Cited by 8 publications

References 32 publications

Collaterals in portal hypertension: anatomy and clinical relevance

Collaterals in portal hypertension: anatomy and clinical relevance

Evaluation of Hepatic Tissue Blood Flow Using Xenon Computed Tomography with Fibrosis Progression in Nonalcoholic Fatty Liver Disease: Comparison with Chronic Hepatitis C

Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function

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