Assessment of splenic perfusion in patients with malignant hematologic diseases and spleen involvement, liver cirrhosis and controls using volume perfusion CT (VPCT): a pilot study.
OBJECTIVE
The aim of this study was to assess splenic perfusion in patients with spleen involvement in malignant hematologic diseases and liver cirrhosis and in controls without hepatosplenic disease using volume perfusion computed tomography.


METHODS
Between October 2009 and December 2011, 14 hematologic patients with known spleen involvement were recruited. An additional 17 consecutive patients without known splenic or liver disease were enrolled as controls, as well as 29 patients with liver cirrhosis and portal hypertension. A 40-second volume perfusion computed tomographic scan of the upper abdomen was performed. Analysis included measurement of splenic volume, blood flow (BF), blood volume (BV), K(trans), and mean transit time (MTT).


RESULTS
In lymphoma patients, mean splenic volume and perfusion parameters were as follows: splenic volume, 1125.34 mL; BF, 61.24 mL/100 mL/min; BV, 16.53 mL/100 mL; K(trans), 37.00 mL/100 mL/min; and MTT, 12.42 seconds. All perfusion values of patients with lymphoma and cirrhosis differed significantly, except for BV, compared to controls. For patients with lymphoma, significant correlations were found between splenic volume and BF (r = -0.683, P = .000), splenic volume and BV (r = -0.525, P = .002), and splenic volume and MTT (r = 0.543, P = .001). During treatment, significant correlations between the diameters of nodular lymphoma target lesions, splenic volume, and the perfusion parameters were present for splenic volume (r = 0.601, P = .002), BF (r = -0.777, P = .000) and BV (r = -0.500, P = .011).


CONCLUSIONS
Volume perfusion computed tomography represents a novel tool for the assessment of splenic perfusion. Preliminary results in patients with spleen involvement reveal lower perfusion values compared to controls or patients with cirrhosis. Therefore, this technique might provide additional information in clinical routine.
Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Straße 3, D-72076 Tübingen, Germany. alexander.sauter@klinikum.uni-tuebingen.de
Alexander W
AW
Sauter
Stefan
S
Feldmann
Daniel
D
Spira
Maximilian
M
Schulze
Ernst
E
Klotz
Wichard
W
Vogel
Claus D
CD
Claussen
Marius S
MS
Horger
D000368:Aged; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008223:Lymphoma / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013160:Splenic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*