Yasukazu Kako1, Koichiro Yamakado2, Wataru Jomoto3, Toshiya Nasada3, Koichiro Asada2, Haruyuki Takaki2, Kaoru Kobayashi2, Takashi Daimon4, Shozo Hirota2. 1. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. y-kako@hyo-med.ac.jp. 2. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. 3. Department of Radiological Technology, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. 4. Department of Biostatistics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Abstract
PURPOSE: To evaluate changes in liver perfusion after occlusion of spontaneous portosystemic shunt and to analyze mechanisms of liver profile improvement. MATERIALS AND METHODS: Liver function changes and portal venous and hepatic arterial blood flow were evaluated using perfusion CT before and after shunt occlusion in 23 patients who underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n = 15) or hepatic encephalopathy (n = 8). RESULTS: Portal venous blood flow was significantly higher at 1 week (278.7 ml/min, 92.7-636.7, p = 0.012), 1 month (290.0 ml/min, 110.1-560.1, p < 0.001) and 3 months (299.6 ml/min, 156.7-618.5, p = 0.033) after shunt occlusion than the baseline (220.9 ml/min, 49.5-566.7). Hepatic arterial liver blood flow became lower than the baseline (132.3 ml/min, 47.9-622.3) after shunt occlusion, but a significant decrease was observed only at 1 month later (107.9 ml/min, 45.8-263.6 p = 0.027). Serum albumin concentration became significantly higher than the baseline (3.4 mg/dl, 1.9-4.5) at 1 month (3.8 mg/dl, 2.3-4.3, p = 0.018) and 3 months (3.9 mg/dl, 2.6-4.3, p = 0.024) after shunt occlusion. CONCLUSION: Shunt occlusion increases portal venous blood flow and decreases hepatic arterial blood flow, thereby improving the liver profile.
PURPOSE: To evaluate changes in liver perfusion after occlusion of spontaneous portosystemic shunt and to analyze mechanisms of liver profile improvement. MATERIALS AND METHODS: Liver function changes and portal venous and hepatic arterial blood flow were evaluated using perfusion CT before and after shunt occlusion in 23 patients who underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n = 15) or hepatic encephalopathy (n = 8). RESULTS: Portal venous blood flow was significantly higher at 1 week (278.7 ml/min, 92.7-636.7, p = 0.012), 1 month (290.0 ml/min, 110.1-560.1, p < 0.001) and 3 months (299.6 ml/min, 156.7-618.5, p = 0.033) after shunt occlusion than the baseline (220.9 ml/min, 49.5-566.7). Hepatic arterial liver blood flow became lower than the baseline (132.3 ml/min, 47.9-622.3) after shunt occlusion, but a significant decrease was observed only at 1 month later (107.9 ml/min, 45.8-263.6 p = 0.027). Serum albumin concentration became significantly higher than the baseline (3.4 mg/dl, 1.9-4.5) at 1 month (3.8 mg/dl, 2.3-4.3, p = 0.018) and 3 months (3.9 mg/dl, 2.6-4.3, p = 0.024) after shunt occlusion. CONCLUSION: Shunt occlusion increases portal venous blood flow and decreases hepatic arterial blood flow, thereby improving the liver profile.