Quantitative hepatic CT perfusion measurement: comparison of Couinaud's hepatic segments with dual-source 128-slice CT.
OBJECTIVE
To compare the quantitative liver computed tomography perfusion (CTP) differences among eight hepatic segments.


METHODS
This retrospective study was based on 72 acquired upper abdomen CTP scans for detecting suspected pancreas tumor. Patients with primary or metastatic liver tumor, any focal liver lesions except simple cyst (<3 cm in diameter), history of liver operation or splenectomy, evidence of liver cirrhosis or invasion of portal vein were excluded. The final analysis included 50 patients (M:F=21:29, mean age=43.2 years, 15-76 years). Arterial liver perfusion (ALP), portal-venous perfusion (PVP), total hepatic perfusion (THP=ALP+PVP), and hepatic perfusion index (HPI) of each hepatic segment were calculated and compared by means of one-way analysis of variance (ANOVA) and the Bonferonni correction method.


RESULTS
Compared to hepatic segments 5, 6, 7 and 8, segments 2 and 3 showed a tendency of higher ALPs, lower PVPs, and higher HPIs, most of which were statistically significant (p<0.05). Hepatic segments 1 and 4 had higher mean values of ALP and HPI and lower mean values of PVP than segments 5, 6, 7 and 8 as well, although no significant differences were detected except for ALP and HPI for liver segments 1 and 7 (p=0.001 and 0.035 respectively), and ALP for liver segments 1 and 5 (p=0.039). Higher ALP and HPI were showed in hepatic segment 3 compared to segment 4 (p=0.000 and 0.000 respectively). No significant differences were found for THP among eight segments.


CONCLUSIONS
Intra-hepatic perfusion differences exist in normal hepatic parenchyma especially between lateral sector (segments 2 and 3) and right lobe (segments 5, 6, 7 and 8). This might have potential clinical significance in liver-perfusion-related protocol design and result analysis.
Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730, People's Republic of China.
Xuan
X
Wang
Hua-dan
HD
Xue
Zheng-Yu
ZY
Jin
Bai-yan
BY
Su
Zhuo
Z
Li
Hao
H
Sun
Yu
Y
Chen
Wei
W
Liu
D000293:Adolescent; D000465:Algorithms; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000556:secondary*; D055420:Perfusion Imaging / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult