title: [Value of liver perfusion imaging of 256-slice CT  in evaluation of the cirrhosis].
abstract: OBJECTIVE
  To investigate the value of liver perfusion imaging of 256-slice CT in evaluating the compensated and decompensated cirrhosis.
  
  
  METHODS
  A total of 20 patients with liver cirrhosis, who were confirmed by liver biopsy, clinical symptoms and imaging, were selected from December 2012 to June 2014. According to the results of liver biopsy and the Child-Pugh classification, the patients were divided into a compensated cirrhosis group (n=8) and a decompensated cirrhosis group (n=12). Eleven cases without liver and spleen diseases were served as a control group. All subjects were under the 256-CT liver perfusion (256-CTP). The data of CTP [hepatic arterial perfusion (HAP), portal venous perfusion (PVP), total liver perfusion (TLP), hepatic perfusion index (HPI)] were obtained according to liver perfusion type, and the data of CTP [liver perfusion (LP), peak enhanced (PE), time to peak (TTP), blood volume (BV)] were obtained according to general perfusion type. Spearman rank correlation was used to analyze the correlation of liver cirrhosis with perfusion parameters. The receiver operating characteristic (ROC) curve was used to predict liver cirrhosis, and the maximized Youden index was served as the optimal cutoff value, then the area under curve, sensitivity and specificity were calculated.
  
  
  RESULTS
  The PVP, TLP and PE values in the control group, the compensated cirrhosis group and the decompensated cirrhosis group were (76.63±37.26), (38.78±16.13) and (36.14± 15.31) mL/(100 mL·min); (98.48±43.58), (55.63±14.47) and (54.41±20.81) mL/(100 mL·min);  (55.62±18.25), (44.11±5.79) and (41.08±7.74) HU, respectively, showing a gradual downward trend and a significant difference among the 3 groups (all P <0.05). HPI values were (19.50±6.08)%, (31.81±16.48)% and (34.47±16.04)%; TTP values were (37.32±8.59), (47.06±14.61), (59.86±20.87) s, respectively, showing a gradual upward trend and significant difference among the 3 groups ( all P<0.05). There was no significant difference in the HAP, LP and BV among the 3 groups (all P>0.05). PVP, TLP, PE and LP were negatively correlated with the process of liver cirrhosis (r=-0.592, -0.567, -0.409, -0.569, all P<0.05), but HPI and TTP were positively correlated with the process of liver cirrhosis (r=0.434 and 0.538, both P<0.05).
  
  
  CONCLUSIONS
  256-CTP could provide useful information for the assessment of liver cirrhosis by measuring a plurality of perfusion parameters. The hepatic microvascular changes in patients with liver cirrhosis could be quantitatively assessed by perfusion CT. TTP shows high efficiency in prediction of liver cirrhosis and decompensated liver cirrhosis.
authors.affiliation: Department of Radiology, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, China.
authors.forename: Yuefu
authors.initials: Y
authors.lastname: Zhan
authors.affiliation: Department of Anesthesiology, Hainan General Hospital, Haikou 570311, China.
authors.forename: Yehua
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Radiology, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, China.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiology, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Radiology, Affiliated Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208, China.
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Han
mesh_terms: D016022:Case-Control Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D055420:Perfusion Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed