title: Xenon computed tomography can evaluate the improvement of hepatic hemodynamics before and after endoscopic injection sclerotherapy.
abstract: BACKGROUND
  Xenon computed tomography (Xe-CT) provides quantitative information on tissue blood flow (TBF). In the present study, Xe-CT was performed in patients with esophagogastric varices (EGV) before and after endoscopic injection sclerotherapy (EIS) to evaluate hepatic blood flow (HBF), hepatic arterial TBF (HATBF) and portal venous TBF (PVTBF).
  
  
  METHODS
  Subjects comprised of 88 patients with EGV (49 men, 39 women, average age 65.8 ± 11.5 years, median age 68 years, 30-86 years) and liver cirrhosis related to either hepatitis C virus (C) (n = 33), hepatitis B virus (B) (n = 3), alcohol (AL) (n = 22), AL + C (n = 7), AL + B (n = 1), B + C + AL (n = 1), nonalcoholic steatohepatitis (NASH) (n = 4), autoimmune hepatitis (AIH) (n = 5), primary biliary cirrhosis (PBC) (n = 2), or cryptogenic (n = 10) were enrolled. All patients, who were enrolled in this study, were performed EIS for prophylaxis. Xe-CT and measurement of the retention rate of indocyanine green 15 min after administration (ICG R15) were performed before and after EIS. Total hepatic TBF (THTBF) and PVTBF/HATBF ratio (P/A) were also calculated.
  
  
  RESULTS
  PVTBF, HATBF, THTBF, P/A and ICG R15 before EIS were 28.3 ± 8.91, 22.5 ± 14.4 and 50.8 ± 17.6 ml/100 ml/min, 1.62 ± 0.71 and 28.8 ± 12.7 %, respectively and those after EIS were 31.9 ± 10.0, 19.3 ± 11.6, and 51.2 ± 17.0 ml/100 ml/min, 1.92 ± 0.84 and 23.6 ± 11.3 %, respectively. PVTBF and P/A after EIS were significantly higher than those before EIS (p = 0.00444, p = 0.0179, respectively), and HATBF and ICG R15 after EIS were significantly lower than those before EIS (p = 0.00129, p < 0.001, respectively).
  
  
  CONCLUSIONS
  Xenon computed tomography showed that PVTBF increased after EIS for EGV and HATBF decreased in response to an increase in PVTBF.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan, hide-bo@marianna-u.ac.jp.
authors: Hideaki
authors: H
authors: Takahashi
authors: Michihiro
authors: M
authors: Suzuki
authors: Ryuta
authors: R
authors: Shigefuku
authors: Miki
authors: M
authors: Okano
authors: Tetsuya
authors: T
authors: Hiraishi
authors: Rei
authors: R
authors: Takagi
authors: Yohei
authors: Y
authors: Noguchi
authors: Nobuhiro
authors: N
authors: Hattori
authors: Moriaki
authors: M
authors: Hatsugai
authors: Kazunari
authors: K
authors: Nakahara
authors: Masaru
authors: M
authors: Okamoto
authors: Minoru
authors: M
authors: Kobayashi
authors: Hiroki
authors: H
authors: Ikeda
authors: Yasunobu
authors: Y
authors: Fukuda
authors: Yoshihiko
authors: Y
authors: Nagase
authors: Toshiya
authors: T
authors: Ishii
authors: Kotaro
authors: K
authors: Matsunaga
authors: Nobuyuki
authors: N
authors: Matsumoto
authors: Chiaki
authors: C
authors: Okuse
authors: Shigeru
authors: S
authors: Sase
authors: Fumio
authors: F
authors: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods; D004932:Esophageal and Gastric Varices / Q000473:pathology / Q000628:therapy*; D005260:Female; D006499:Hepatic Artery / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000378:metabolism; D011446:Prospective Studies; D012039:Regional Blood Flow; D015911:Sclerotherapy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014978:Xenon
chemical_list: D014978:Xenon
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