[Whole-liver perfusion imaging by multi-slice spiral computed tomography based on Couinaud segments for evaluation of the blood flow state in patients with hepatitis B cirrhosis]

Zhonghua Gan Zang Bing Za Zhi. 2014 Nov;22(11):817-21. doi: 10.3760/cma.j.issn.1007-3418.2014.11.004.
[Article in Chinese]


Objective: To investigate the blood flow characteristics of hepatitis B cirrhosis based on Couinaud's hepatic segments and to analyze the correlation between perfusion parameters of liver cirrhosis in the hepatic segments and between the different Child-Pugh classifications by using the pattern of whole liver perfusion detected by multi-slice spiral computed tomography (MSCT).

Methods: Whole-liver perfusion enhanced CT imaging scan was performed for 51 patients with hepatitis B cirrhosis (including 24 classified as Child-Pugh A, 19 as Child-Pugh B, and 8 as Child-Pugh C) and 20 patients without any liver abnormalities (who served as the control group).The perfusion parameters of Couinaud's segments were measured in order to compare the blood perfusion differences among the Couinaud's hepatic segments in liver cirrhosis. The blood flow characteristics were analyzed for each lobe and compared between groups, and the time to peak and peak of enhancement values of the aorta and portal veins and spleen were recorded and compared between groups.The F-test was used for statistical analysis.

Results: The liver cirrhosis group showed higher time to peak for aorta and portal veins and spleen but lower peak of enhancement values than the control group. The hepatic arterial perfusion (HAP) was significantly higher in segment 3 than in segment 7 were (11.40+/- 5.72 vs.9.46+/-5.18 mL/min/100 mL; P less than 0.05). In addition, the differences of the portal venous perfusion (PVP) and total hepatic perfusion (THP) were significant between the liver lobes in various groups (P less than 0.05). The HAP and hepatic perfusion index (HPI) were not significantly different between the groups, but the HAP and HPI in every lobe were higher in the Child C subgroup than in either the Child A or Child B subgroups.

Conclusion: The cirrhotic liver has different blood flow in the various Couinaud's segments. Whole-liver perfusion MSCT can reflect the hemodynamic changes of liver cirrhosis and Child-Pugh classification, and as such may be helpful for distinguishing the normal liver from the cirrhotic liver.

MeSH terms

  • Hemodynamics
  • Hepatic Artery
  • Hepatitis B / complications*
  • Humans
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Cirrhosis / etiology
  • Liver Neoplasms
  • Perfusion
  • Perfusion Imaging
  • Portal Vein
  • Spleen
  • Tomography, Spiral Computed*