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CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a...

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Autores principales: Talakić, Emina, Schaffellner, Silvia, Kniepeiss, Daniela, Mueller, Helmut, Stauber, Rudolf, Quehenberger, Franz, Schoellnast, Helmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579174/
https://www.ncbi.nlm.nih.gov/pubmed/28321540
http://dx.doi.org/10.1007/s00330-017-4788-x
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author Talakić, Emina
Schaffellner, Silvia
Kniepeiss, Daniela
Mueller, Helmut
Stauber, Rudolf
Quehenberger, Franz
Schoellnast, Helmut
author_facet Talakić, Emina
Schaffellner, Silvia
Kniepeiss, Daniela
Mueller, Helmut
Stauber, Rudolf
Quehenberger, Franz
Schoellnast, Helmut
author_sort Talakić, Emina
collection PubMed
description OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. RESULTS: The Spearman correlation coefficient was −0.53 (p < 0.05) between SAF and HVPG, and −0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CONCLUSION: CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. KEY POINTS: • SAF and SCL are statistically significantly correlated with HVPG • SCL showed stronger correlation with HVPG than SAF • 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH • HAF, PVF and HPI showed no statistically significant correlation with HVPG
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spelling pubmed-55791742017-09-18 CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension? Talakić, Emina Schaffellner, Silvia Kniepeiss, Daniela Mueller, Helmut Stauber, Rudolf Quehenberger, Franz Schoellnast, Helmut Eur Radiol Computed Tomography OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. RESULTS: The Spearman correlation coefficient was −0.53 (p < 0.05) between SAF and HVPG, and −0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CONCLUSION: CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. KEY POINTS: • SAF and SCL are statistically significantly correlated with HVPG • SCL showed stronger correlation with HVPG than SAF • 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH • HAF, PVF and HPI showed no statistically significant correlation with HVPG Springer Berlin Heidelberg 2017-03-20 2017 /pmc/articles/PMC5579174/ /pubmed/28321540 http://dx.doi.org/10.1007/s00330-017-4788-x Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Computed Tomography
Talakić, Emina
Schaffellner, Silvia
Kniepeiss, Daniela
Mueller, Helmut
Stauber, Rudolf
Quehenberger, Franz
Schoellnast, Helmut
CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title_full CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title_fullStr CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title_full_unstemmed CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title_short CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
title_sort ct perfusion imaging of the liver and the spleen in patients with cirrhosis: is there a correlation between perfusion and portal venous hypertension?
topic Computed Tomography
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579174/
https://www.ncbi.nlm.nih.gov/pubmed/28321540
http://dx.doi.org/10.1007/s00330-017-4788-x
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