Evaluation of quantitative portal venous, hepatic arterial, and total hepatic tissue blood flow using xenon CT in alcoholic liver cirrhosis-comparison with liver cirrhosis related to hepatitis C virus and nonalcoholic steatohepatitis.
OBJECTIVE
Xenon computed tomography (Xe-CT) is a noninvasive method of quantifying and visualizing tissue blood flow (TBF). For the liver, Xe-CT allows separate measurement of hepatic arterial and portal venous TBF. The present study evaluated the usefulness of Xe-CT as a noninvasive diagnostic procedure for measuring hepatic TBF in alcoholic liver cirrhosis (AL-LC), compared with liver cirrhosis related to nonalcoholic steatohepatitis (NASH), (NASH-LC), and hepatitis C virus (HCV), (C-LC).


METHODS
Xe-CT was performed on 22 patients with AL-LC, 7 patients with NASH-LC, and 24 patients with C-LC. Severity of LC was classified according to Child-Pugh classification. Correlations between hepatic TBF, Child-Pugh classification, and indocyanin green retention (ICG) rate after 15 minutes (ICG15R) were examined. Correlations of hepatic TBF in Child-Pugh class A to AL-LC, NASH-LC, and C-LC were also examined.


RESULTS
Portal venous TBF (PVTBF) displayed a significant negative correlation with Child-Pugh score and ICG15R (r = -0.432, p < 0.01, r = -0.442, p < 0.01, respectively). Moreover, ICG15R displayed a significant positive correlation with Child-Pugh score (r = 0.661, p < 0.001). Meanwhile, mean PVTBF and total hepatic TBF (THTBF) was significantly lower in AL-LC than in C-LC (p < 0.05). Mean PVTBF was significantly lower in Child-Pugh class A to AL-LC and NASH-LC than in that to C-LC (p < 0.05). Similarly, mean THTBF was significantly lower in Child-Pugh class A to NASH-LC than in that to C-LC (p < 0.05).


CONCLUSIONS
Measurement of hepatic TBF using Xe-CT is useful as a noninvasive, objective method of assessing the state of the liver in chronic liver disease.
Takahashi
Hideaki
H
Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University, School of Medicine, 2-16-1 Sugao Miyamaeku, Kawasaki, 216-8511, Japan. hide-bo@marianna-u.ac.jp
Suzuki
Michihiro
M
Ikeda
Hiroki
H
Kobayashi
Minoru
M
Sase
Shigeru
S
Yotsuyanagi
Hiroshi
H
Maeyama
Shiro
S
Iino
Shiro
S
Itoh
Fumio
F
D000368:Aged; D001783:Blood Flow Velocity; D005234:Fatty Liver / Q000503:physiopathology*; D005260:Female; D006499:Hepatic Artery; D006526:Hepatitis C; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000503:physiopathology / Q000821:virology*; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D014057:Tomography, X-Ray Computed; D014978:Xenon
D014978:Xenon