Multislice computer tomography perfusion imaging of the hepatosplenic zone in patients with diffuse liver diseases


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Abstract

Computed tomography perfusion (CTP) imaging has been used since the late 1980s - early 1990s, when an assessment of liver perfusion was proposed. Recently, the question of the diagnostic informativity of the method and the interpretation of these perfusion indices in a spectrum of numerous diseases has been actualized. The CTP in the diagnostic algorithm in patients with fibrosis or cirrhosis in domestic clinical practice is not widely used. The article considers the current state of the problem of diagnosing liver fibrosis as a potentially reversible process, cirrhosis and its subsequent complications, the use of various methods for the diagnosis of diffuse liver diseases, including CTP, in order to assess the dynamics of fibrotic, cirrhotic and hemodynamic changes. A review of data on microcirculatory changes in the liver on the background of fibrosis, the formation of arteriovenous shunts, the diagnosis of tumors and the use of CTP to compare the severity of hepatic dysfunction and changes in perfusion parameters in liver diseases is presented. The necessity of using CTP for the diagnosis of the initial manifestations of liver fibrosis and cirrhosis, their subsequent dynamics and evaluation of the effectiveness of therapy is substantiated. It is emphasized that due to the limited data on dynamically developing pathological changes in the liver vasculature during its fibrosis and cirrhosis, the use of CTP becomes relevant for assessing impaired hepatic blood flow, the relationship between the degree of fibrotic/cirrhotic changes and parametric indicators.

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About the authors

Elizaveta A. Mezikova

Siberian State Medical University

Email: mezikova-liza@mail.ru
1st year graduate student

V. D Zavadovskaya

Siberian State Medical University

E. V Beloborodova

Siberian State Medical University

I. V Dolgalev

Siberian State Medical University

O. S Tonkikh

Siberian State Medical University

References

  1. Борисов А.Е., Кащенко В.А. Цирроз печени и портальная гипертензия. 2009. 112 с.
  2. Dufour M.C., Stinson F.S., Caces M.F. Trends in cirrhosis morbidity and mortality. Seminars Liver Disease.1993;13(2):109-25.
  3. Giannelli G., Quaranta V., Antonaci S. Tissue remodeling in liver diseases. Histology. Histopathology. 2003;(18):1267-74.
  4. Lotersztajn S., Julien B., Teixeira-Clerc F., et al. Hepatic fibrosis: molecular mechanisms and drug targets. Ann Rev Pharmacol Toxicol. 2005;(45):605-28.
  5. Gonzalo L.T. A potential strategy to treat liver fibrosis: Drug targeting to hepatic stellate cells applying. 2006.
  6. Eipel C., Abshagen K., Vollmar B. Regulation of hepatic blood flow: The hepatic arterial buffer response revisited. World J. Gastroenterol. 2010;16(48):6046-57.
  7. Farci P., Roskams T., Chessa L., et al. Long-term benefit of interferon alpha therapy of chronic hepatitis D: regression of advanced hepatic fibrosis. Gastroenterology. 2004;126(7):1740-49.
  8. Fowell A.J., Iredale J.P. Emerging therapies for liver fibrosis. Digestive Diseases. 2006;24:174-83.
  9. Friedman S.L., Bansal M.B. Reversal of hepatic fibrosis-fact or fantasy? Hepatology. 2006; 43:82-8.
  10. Piccinino F., Sagnelli E., Pasquale G., et al. Complications following percutaneuous liver biopsy -a multicenter retrospective study on 68276 biopsies. J. Hepatol. 1986;2:165-73.
  11. Попов А.В., Ганеева Е.Р., Ершова А.И. Изменения центральной и печеночной гемодинамики в периоперационном периоде у больных холелитиазом. Медицинский альманах. 2013;(5):105-7.
  12. Затевахин И.И., Цициашвили М.Ш., Дзарасова Г.Ж. Возможности допплеровской сонографии в оценке функционального состояния печени при механической желтухе. Анналы хирургической гепатологии. 2001;(1):113-24.
  13. Малаханов В.А., Селиверстов П.В. Лучевая диагностика при стенозирующих поражениях желчевыводящих путей (обзор литературы). Бюллетень ВСНЦ СО РАМН. 2017;1(113):202-14. Malakhanov V.A., Seliverstov PV Radiological diagnosis of stenotic lesions of the biliary tract (literature review). Byulleten' VSNTs SO RAMN. 2017;1(113):202-14.
  14. Van Beers B.E., Leconte I., Materne R., et al. Hepatic perfusion parameters in chronic liver disease: dynamic CT measurements correlated with disease severity. Am J. Roentgenol. 2001;176:667-73.
  15. Фомина С.В., Завадовская В.Д., Юсубов М.С. Контрастные препараты для ультразвукового исследования. Бюллетень сибирской медицины. 2011;6:137-41.
  16. Palaniyappan N., Cox E., Bradley C., et al. Неинвазивная оценка портальной гипертензии с помощью количественной магнитно-резонансной томографии. J. Hepatol. 2016;65:1131-39.
  17. Dulai P.S., Sirlin C.B., Loomba R. Магнитно-резонансная томография и эластография в качестве методов неинвазивной количественной оценки стеатоза и фиброза при неалкогольной жировой болезни печени: от клинических исследований к клинической практике. J. Hepatol. 2016;65:1006-16.
  18. Кулюшина Е.А. Возможности магнитно-резонансной томографии в дифференциальной диагностике цирроза печени и гепатоцеллюлярной карциномы. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2009;5:20-3.
  19. Susanne B., Ihab K., Steven S., Jeanne C. Can imaging modalities diagnose and stage hepatic fibrosis and cirrhosis accurately? J. Hepatol.2009;50:17-35. doi: 10.1016/j.jhep.2008.10.016.
  20. Ogul H., Kantarci M., Genç B., et al. Perfusion CT imaging of the liver: review of clinical applications. Diagnosic and Interventional Radiology 2014;20:379-89. doi: 10.5152/dir.2014.13396.
  21. Kang S.E., Lee J.M., Klotz E., Kyung W.K. Quantitative color mapping of the arterial enhancement fraction in patients with diffuse liver disease. Am J. Roentgenol. 2011;197:876-83. doi: 10.2214/AJR.10.5943.
  22. Sahani D. Perfusion CT: an overview of technique and clinical applications. 2010.
  23. Spira D., Schulze M., Sauter A., et al. Volume perfusion-CT of the liver: Insights and applications. Eur J. Radiol. 2012;81(7):1471-78. Doi: 10.1016/j. ejrad.2011.04.010.
  24. Hansen M.L., Norling R., Lauridsen C. Computed tomography (CT) Perfusion in abdominal cancer: technical aspects. Diagnostics. 2013;3(2):261-70. doi: 10.3390/diagnostics3020261.
  25. Guan S., Zhao W.D., Zhou K.R., et al. CT perfusion at early stage of hepatic diffuse disease. World Journal of Gastroenterology. 2005;11:3465-67.
  26. Wang L., Fan J., Ding X., et al. Assessment of liver fibrosis in the early stages with perfusion CT. Int J. Clin Exp Med. 2015;8(9):15276-82.
  27. Fischer M.A., Marquez H.P., Gordic S., et al. Arterio-portal shunts in the cirrhotic liver: perfusion computed tomography for distinction of arterialized for pseodolesions from hepatocellular carcinoma. European Radiology. 2017;(3):1074-80. Doi:10.W07/s00330-016-4432-1.
  28. Долгушин М.Б., Тулин П.Е., Оджарова А.А. КТ-перфузия в дифференциальной диагностике опухолей печени. Медицинская визуализация. 2015;5:18.
  29. Тарасенко С.В., Натальский А.А., Зайцев О.В. Нозологическая структура синдрома механической желтухи. Анналы хирургии. 2012;(1):63-
  30. Talakic E., Schaffellner S., Kniepeiss D., et al. CT-perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension. Hepatol Res. 2017;27(10):4173-80. Doi: 10.1007/ s00330-017-4788-x.
  31. Motosugi U., Ichikawa T., Morisaka H., et al. Multi-organ perfusion CT in the abdomen using a 320-detector row CT scanner: Preliminary results of perfusion changes in the liver, spleen, and pancreas of cirrhotic patients. Eur J Radiol. 2012;81(10):2533 37. doi: 10.1016/j.ejrad.2011.11.054
  32. Suzuki T., Yamada A., Komatsu D., et al. Evaluation of splenic perfusion and spleen size using dynamic computed tomography: Usefulness in assessing degree of liver fibrosis. Hepatol Res. 2018;48(1):87-93. doi: 10.1111/hepr.12900.
  33. Дыкан И.Н., Тарасюк Б.А., Полищук Е.В. Мультидетекторная компьютерная перфузиогра фия печени при хронических диффузных заболеваниях. Лучевая диагностика, лучевая терапия. 2011;4:8-13. Dykan I.N., Tarasyuk B.A., Polishchuk E.V. Multi-detector computer perfusion of the liver in chronic diffuse diseases. Luchevaya diagnostika, luchevaya terapiya. 2011;4:8-13.
  34. Ronot M., Asselah T., Paradis V., et al. Liver fibrosis in chronic hepatitis C. virus infection: differentiating minimal from intermediate fibrosis with perfusion. Radiology. 2010;256(1):135-42. Doi: 10.1148/ radiol.10091295.
  35. Meijerink M., van Waesberghe J.H., van Schaik C., et al. Perfusion CT and US of colorectal cancer liver metastases: a correlative study of two dynamic imaging modalities. Ultrasound in Medicine and Biology. 2010;36(10):1626-36. Doi: 10.1016/j. ultrasmedbio.2010.06.015.

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