Assessment of the hepatic microvascular changes in liver cirrhosis by perfusion computed tomography

Abstract

Aim: To assess the hepatic microvascular parameters in patients with liver cirrhosis by perfusion computed tomography (CT).

Methods: Perfusion CT was performed in 29 patients without liver disease (control subjects) and 39 patients with liver cirrhosis, including 22 patients with compensated cirrhosis and 17 patients with decompensated cirrhosis, proved by clinical and laboratory parameters. CT cine-scans were obtained over 50 s beginning with the injection of 50 mL of contrast agent. Hepatic microvascular parameters, mean transit time (MTT) and permeability surface area product (PS) were obtained with the Perfusion 3 software (General Electric, ADW 4.2).

Results: The overall differences of MTT and PS between control subjects, patients with compensated cirrhosis and those with decompensated cirrhosis were statistically significant (P = 0.010 and P = 0.002, respectively). MTT values were 15.613 +/- 4.1746 s, 12.592 +/- 4.7518 s, and 11.721 +/- 4.5681 s for the three groups, respectively, while PS were 18.945 +/- 7.2347 mL/min per 100 mL, 22.767 +/- 8.3936 mL/min per 100 mL, and 28.735 +/- 13.0654 mL/min per 100 mL. MTT in decompensated cirrhotic patients were significantly decreased compared to controls (P = 0.017), whereas PS values were remarkably increased (P = 0.001).

Conclusion: The hepatic microvascular changes in patients with liver cirrhosis can be quantitatively assessed by perfusion CT. Hepatic microvascular parameters (MTT and PS), as measured by perfusion CT, were significantly altered in decompensated cirrhosis.

Figure 1

Distribution of hepatic microvascular parameters in controls and cirrhotics. Box-whisker plots are shown, in which the lower box boundary indicates the 25th percentile, the line within the box marks the median and the top box boundary indicates the 75th percentile. Error bars below and above the boxes indicate 10th and 90th percentiles. Other data are represented as individual dots. The graphs show box-whisker plots of mean transit time (MTT) (A) and permeability surface area product (PS) (B). n: Number of patients.

Figure 2

The box-whisker plots show the distribution of hepatic microvacular parameters in controls as well as in compensated and decompensated cirrhosis patients. The values of MTT (A) and PS (B) are shown.

Figure 3

MTT and PS maps between controls and cirrhotic patients. MTT in a control subject (A) was higher than in a cirrhotic patient (B). PS in a control subject (C) was lower than in a cirrhotic patient (D).