Role of dual-source CT low-dose whole liver perfusion imaging in evaluating liver blood perfusion after transjugular intrahepatic portosystemic shunt in cirrhotic patients with portal hypertension

Objective To investigate the role of dual-source CT low-dose whole liver perfusion imaging in evaluating the hemodynamic changes in liver parenchyma before and after transjugular intrahepatic portosystemic shunt( TIPS) in cirrhotic patients with portal hypertension. Methods A total of 52 cirrhosis patients with portal hypertension underwent whole liver perfusion CT scan 2 days before TIPS and at1 week after TIPS. The image quality was evaluated and a post-processing workstation was used to observe the changes in perfusion parameters. Paired t-test was applied for comparison between two groups,and pearson linear correlation was applied for correlation analysis. Results Hepatic arterial perfusion( HAP) increased from 19. 85 ml /( min·100 ml) ± 9. 48 ml /( min·100 ml) before TIPS to 29. 36 ml /( min·100 ml) ± 13. 65 ml/( min·100 ml) after TIPS( t =-6. 161,P = 0. 003),and the hepatic arterial perfusion index( HPI) increased from 54. 32% ± 19. 60% before TIPS to 64. 11% ± 11. 19% after TIPS( t =-6. 202,P = 0. 029). Portal vein perfusion( PVP)was reduced from 19. 75 ml /( min·100 ml) ± 10. 60 ml /( min·100 ml) before TIPS to 16. 13 ml /( min·100 ml) ± 8. 60 ml /( min·100ml) after TIPS,and total liver perfusion( TLP) increased from 36. 14 ml /( min ·100 ml) ± 16. 61 ml /( min ·100 ml) before TIPS to44. 12 ml /( min·100 ml) ± 14. 60 ml /( min·100 ml) after TIPS( both P > 0. 05). The mean effective radiation dose of whole liver perfusion scan was 16. 5 m Sv. PVP,TLP,and HPI were significantly correlated with the injection rate of contrast agent( r = 0. 992,P = 0. 001; r=-0. 903,P = 0. 036; r =-0. 899,P = 0. 038). HAP,PVP,and TLP were negatively correlated with the sample size( r =-0. 922,P =0. 026; r =-0. 943,P = 0. 016; r =-0. 998,P < 0. 001). TLP was positively correlated with the voltage of X-ray tube and scantimes( r =0. 896,P = 0. 039; r = 0. 907,P = 0. 033). Conclusion Dual-source CT low-dose whole liver perfusion can be used to observe the hemodynamic changes in cirrhotic patients with portal hypertension before and after TIPS and provide a reference for preoperative evaluation and therapeutic effect evaluation.