Computed tomography perfusion in differentiating portal hypertension: A correlation study with hepatic venous pressure gradient.

Content Provider	Europe PMC
Author	Dong, Jian Zhang, Yu Wu, Yi-Fan Yue, Zhen-Dong Fan, Zhen-Hua Zhang, Chun-Yan Liu, Fu-Quan Wang, Lei
Copyright Year	2023
Abstract	BACKGROUNDHepatic venous pressure gradient (HVPG) is the gold standard for diagnosis of portal hypertension (PH), invasiveness and potential risks in the process of measurement limited its widespread use. AIMTo investigate the correlation of computed tomography (CT) perfusion parameters with HVPG in PH, and quantitatively assess the blood supply changes in liver and spleen parenchyma before and after transjugular intrahepatic portosystemic shunt (TIPS).METHODSTwenty-four PH related gastrointestinal bleeding patients were recruited in this study, and all patients were performed perfusion CT before and after TIPS surgery within 2 wk. Quantitative parameters of CT perfusion, including liver blood volume (LBV), liver blood flow (LBF), hepatic arterial fraction (HAF), spleen blood volume (SBV) and spleen blood flow (SBF), were measured and compared before and after TIPS, and the quantitative parameters between clinically significant PH (CSPH) and non-CSPH (NCSPH) group were also compared. Then the correlation of CT perfusion parameters with HVPG were analyzed, with statistical significance as P < 0.05.RESULTSFor all 24 PH patients after TIPS, CT perfusion parameters demonstrated decreased LBV, increased HAF, SBV and SBF, with no statistical difference in LBF. Compared with NCSPH, CSPH showed higher HAF, with no difference in other CT perfusion parameters. HAF before TIPS showed positive correlation with HVPG (r = 0.530, P = 0.008), while no correlation was found in other CT perfusion parameters with HVPG and Child-Pugh scores.CONCLUSIONHAF, an index of CT perfusion, was positive correlation with HVPG, and higher in CSPH than NCSPH before TIPS. While increased HAF, SBF and SBV, and decreased LBV, were found after TIPS, which accommodates a potential non-invasive imaging tool for evaluation of PH.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10190718&blobtype=pdf
Journal	World Journal of Gastrointestinal Surgery [World J Gastrointest Surg]
Volume Number	15
DOI	10.4240/wjgs.v15.i4.664
PubMed Central reference number	PMC10190718
Issue Number	4
PubMed reference number	37206083
e-ISSN	19489366
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2023-04-01
Access Restriction	Open
Rights License	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Portal hypertension Transjugular intrahepatic portosystemic shunt Hepatic vein pressure gradient Perfusion Computed tomography
Content Type	Text
Resource Type	Article
Subject	Gastroenterology