Assessment of Liver Fibrosis in the Early Stages with Perfusion CT

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2015 Dec 3

PMID 26629014

Citations 6

Authors

Liuhong Wang

Jingjing Fan

Xinfa Ding

Jianzhong Sun

Minming Zhang

Affiliations

Soon will be listed here.

Abstract

Objectives: This work aims to assess the feasibility of perfusion CT in diagnosis of liver fibrosis in the early stage.

Materials And Methods: Solutions of carbon tetrachloride (CCL4) were injected into the peritoneum of 45 rabbits to establish rabbit models of liver fibrosis. Perfusion CT were performed at 4-, 8-, 12- and 16- week after injection. The parametric perfusion indices of blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) on perfusion maps were measured. Liver samples were scored as F0, F1, F2, F3, F4 for fibrosis.

Results: In 50 rabbits, 23 rabbits survived. Of these survival rabbits, 5 rabbits were histopathologically scored as F0, 7 rabbits were F1, 8 rabbits were F2, and 3 rabbits were F3. For relatively small number of F3, multiple comparisons were made for F0 vs. F1, F1 vs. F2 and F0 vs. F2. A statistically significant difference was observed in PVP, BV, BF, ALP and HPI between F1 vs. F2 and F0 vs. F2, whereas a significant statistical difference was only achieved in PVP between F0 vs. F1. In the early stage of liver fibrosis PVP decreased with the progression of liver fibrosis, whereas HPI, ALP and BF increased with the progression of liver fibrosis. BV had no marked change.

Conclusions: Perfusion CT is feasible in diagnosis of early stage of liver fibrosis. PVP appears to be the most promising parametric perfusion index.

Citing Articles

Liver injury monitoring, fibrosis staging and inflammation grading using T1rho magnetic resonance imaging: an experimental study in rats with carbon tetrachloride intoxication.

Xie S, Qi H, Li Q, Zhang K, Zhang L, Cheng Y BMC Gastroenterol. 2020; 20(1):14.

PMID: 31941457 PMC: 6964054. DOI: 10.1186/s12876-020-1161-3.

The diagnostic nomogram of platelet-based score models for hepatic alveolar echinococcosis and atypical liver cancer.

Du Q, Wang Y, Guan S, Hu C, Li M, Zhou L Sci Rep. 2019; 9(1):19403.

PMID: 31852926 PMC: 6920149. DOI: 10.1038/s41598-019-55563-3.

Liver Fibrosis Conventional and Molecular Imaging Diagnosis Update.

Li S, Sun X, Chen M, Ying Z, Wan Y, Pi L J Liver. 2019; 8(1).

PMID: 31341723 PMC: 6653681.

CT predicts liver fibrosis: Prospective evaluation of morphology- and attenuation-based quantitative scores in routine portal venous abdominal scans.

Obmann V, Mertineit N, Berzigotti A, Marx C, Ebner L, Kreis R PLoS One. 2018; 13(7):e0199611.

PMID: 29990333 PMC: 6038998. DOI: 10.1371/journal.pone.0199611.

Correlation between acoustic radiation force impulse (ARFI)-based tissue elasticity measurements and perfusion parameters acquired by perfusion CT in cirrhotic livers: a proof of principle.

Esser M, Bitzer M, Kolb M, Fritz J, Kurucay M, Ruff C J Med Ultrason (2001). 2018; 46(1):81-88.

PMID: 29948475 DOI: 10.1007/s10396-018-0886-x.

References

Kovac J, Dakovic M, Stanisavljevic D, Alempijevic T, Jesic R, Seferovic P . Diffusion-weighted MRI versus transient elastography in quantification of liver fibrosis in patients with chronic cholestatic liver diseases. Eur J Radiol. 2011; 81(10):2500-6. DOI: 10.1016/j.ejrad.2011.10.024. View

Chen B, Hsu C, Yu C, Wei S, Kao J, Lee H . Dynamic contrast-enhanced magnetic resonance imaging with Gd-EOB-DTPA for the evaluation of liver fibrosis in chronic hepatitis patients. Eur Radiol. 2011; 22(1):171-80. DOI: 10.1007/s00330-011-2249-5. View

Meijerink M, van Waesberghe J, van der Weide L, van den Tol P, Meijer S, van Kuijk C . Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases. Eur Radiol. 2008; 18(10):2345-54. DOI: 10.1007/s00330-008-0996-8. View

Hashimoto K, Murakami T, Dono K, Hori M, Kim T, Kudo M . Assessment of the severity of liver disease and fibrotic change: the usefulness of hepatic CT perfusion imaging. Oncol Rep. 2006; 16(4):677-83. View

Gulberg V, Haag K, Rossle M, Gerbes A . Hepatic arterial buffer response in patients with advanced cirrhosis. Hepatology. 2002; 35(3):630-4. DOI: 10.1053/jhep.2002.31722. View

MORENO A, BURCHELL A, Rousselot L, PANKE W, Slafsky F, BURKE J . Portal blood flow in cirrhosis of the liver. J Clin Invest. 1967; 46(3):436-45. PMC: 297064. DOI: 10.1172/JCI105545. View

Fowell A, Iredale J . Emerging therapies for liver fibrosis. Dig Dis. 2006; 24(1-2):174-83. DOI: 10.1159/000090320. View

Ronot M, Asselah T, Paradis V, Michoux N, Dorvillius M, Baron G . Liver fibrosis in chronic hepatitis C virus infection: differentiating minimal from intermediate fibrosis with perfusion CT. Radiology. 2010; 256(1):135-42. DOI: 10.1148/radiol.10091295. View

Zhong L, Wang W, Xu J . Clinical application of hepatic CT perfusion. World J Gastroenterol. 2009; 15(8):907-11. PMC: 2653413. DOI: 10.3748/wjg.15.907. View

10.

Bonekamp S, Kamel I, Solga S, Clark J . Can imaging modalities diagnose and stage hepatic fibrosis and cirrhosis accurately?. J Hepatol. 2008; 50(1):17-35. DOI: 10.1016/j.jhep.2008.10.016. View

11.

Friedman S, Bansal M . Reversal of hepatic fibrosis -- fact or fantasy?. Hepatology. 2006; 43(2 Suppl 1):S82-8. DOI: 10.1002/hep.20974. View

12.

Seeff L . Natural history of chronic hepatitis C. Hepatology. 2002; 36(5 Suppl 1):S35-46. DOI: 10.1053/jhep.2002.36806. View

13.

Castera L . Non-invasive diagnosis of steatosis and fibrosis. Diabetes Metab. 2009; 34(6 Pt 2):674-9. DOI: 10.1016/S1262-3636(08)74603-2. View

14.

Friedman S . Liver fibrosis -- from bench to bedside. J Hepatol. 2003; 38 Suppl 1:S38-53. DOI: 10.1016/s0168-8278(02)00429-4. View

15.

Roskams T, Baptista A, Bianchi L, Burt A, Callea F, Denk H . Histopathology of portal hypertension: a practical guideline. Histopathology. 2002; 42(1):2-13. DOI: 10.1046/j.1365-2559.2003.01464.x. View

16.

Piccinino F, Sagnelli E, Pasquale G, Giusti G . Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol. 1986; 2(2):165-73. DOI: 10.1016/s0168-8278(86)80075-7. View

17.

Guan S, Zhao W, Zhou K, Peng W, Mao J, Tang F . CT perfusion at early stage of hepatic diffuse disease. World J Gastroenterol. 2005; 11(22):3465-7. PMC: 4316005. DOI: 10.3748/wjg.v11.i22.3465. View

18.

Hagiwara M, Rusinek H, Lee V, Losada M, Bannan M, Krinsky G . Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging--initial experience. Radiology. 2008; 246(3):926-34. DOI: 10.1148/radiol.2463070077. View

19.

Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F . Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology. 2005; 41(1):48-54. DOI: 10.1002/hep.20506. View

20.

Koinuma M, Ohashi I, Hanafusa K, Shibuya H . Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis. J Magn Reson Imaging. 2005; 22(1):80-5. DOI: 10.1002/jmri.20344. View