Objective: To test the value of whole-liver perfusion in demonstrating liver angiography and assessing the degree of liver cirrhosis.
Methods: Forty patients with confirmed liver cirrhosis (patient group) and twenty patients without any liver abnormalities (control group) were prospectively enrolled in this study. All patients underwent whole-liver perfusion CT scans. The time density curve (TDC), hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and total liver perfusion (TLP) were measured using a special software for the whole-liver perfusion. The CTA imaging of hepatic vessels was obtained by reconstructing the single scanning images. The peak values and time to reach peak values of abdominal aorta and portal veins and the hepatic perfusion parameters were measured. The collateral vessels were observed.
Results: Delay in the time to reach peak values and reduced peak values of the abdominal aorta and portal veins in patients with live cirrhosis were observed compared to the controls (P < 0.05). The HAP value in Child A was higher than those in Child B, C and the controls (P < 0.05). The HPP and TLP values decreased gradually in Child A, B and C, all with significance compared to the controls (P < 0.05). The HPI values in Child C was higher than those in other groups (P < 0.05). Reconstructed CTA images showed that different collateral vessels were developed at the end-stage of chronic liver cirrhosis due to severe portal hypertension. The parameters of HPP and TLP in the group with more collateral vessels development were greater than those in other groups (P < 0.05).
Conclusion: The whole-liver perfusion is valuable in evaluation the severity of liver cirrhosis. The CT angiography can precisely illustrate the hepatic vascular anatomy of liver and the collateral vessels.