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Xenon computed tomography can evaluate the improvement of hepatic hemodynamics before and after endoscopic injection sclerotherapy

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Xenon computed tomography (Xe-CT) provides quantitative information on tissue blood flow (TBF). In the present study, Xe-CT was performed in patients with esophagogastric varices (EGV) before and after endoscopic injection sclerotherapy (EIS) to evaluate hepatic blood flow (HBF), hepatic arterial TBF (HATBF) and portal venous TBF (PVTBF).

Methods

Subjects comprised of 88 patients with EGV (49 men, 39 women, average age 65.8 ± 11.5 years, median age 68 years, 30–86 years) and liver cirrhosis related to either hepatitis C virus (C) (n = 33), hepatitis B virus (B) (n = 3), alcohol (AL) (n = 22), AL + C (n = 7), AL + B (n = 1), B + C + AL (n = 1), nonalcoholic steatohepatitis (NASH) (n = 4), autoimmune hepatitis (AIH) (n = 5), primary biliary cirrhosis (PBC) (n = 2), or cryptogenic (n = 10) were enrolled. All patients, who were enrolled in this study, were performed EIS for prophylaxis. Xe-CT and measurement of the retention rate of indocyanine green 15 min after administration (ICG R15) were performed before and after EIS. Total hepatic TBF (THTBF) and PVTBF/HATBF ratio (P/A) were also calculated.

Results

PVTBF, HATBF, THTBF, P/A and ICG R15 before EIS were 28.3 ± 8.91, 22.5 ± 14.4 and 50.8 ± 17.6 ml/100 ml/min, 1.62 ± 0.71 and 28.8 ± 12.7 %, respectively and those after EIS were 31.9 ± 10.0, 19.3 ± 11.6, and 51.2 ± 17.0 ml/100 ml/min, 1.92 ± 0.84 and 23.6 ± 11.3 %, respectively. PVTBF and P/A after EIS were significantly higher than those before EIS (p = 0.00444, p = 0.0179, respectively), and HATBF and ICG R15 after EIS were significantly lower than those before EIS (p = 0.00129, p < 0.001, respectively).

Conclusions

Xenon computed tomography showed that PVTBF increased after EIS for EGV and HATBF decreased in response to an increase in PVTBF.

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Abbreviations

Xe-CT:

Xenon computed tomography

TBF:

Tissue blood flow

EGV:

Esophagogastric varices

HBF:

Hepatic blood flow

HATBF:

Hepatic arterial tissue blood flow

PVTBF:

Portal venous tissue blood flow

THTBF:

Total hepatic tissue blood flow

P/A:

Portal venous tissue blood flow/hepatic arterial tissue blood flow ratio

CLD:

Chronic liver disease

LC:

Liver cirrhosis

B:

Hepatitis B virus

C:

Hepatitis C virus

AL:

Alcohol

NASH:

Nonalcoholic steatohepatitis

AIH:

Autoimmune hepatitis

PBC:

Primary biliary cirrhosis

EIS:

Endoscopic injection sclerotherapy

ICG R15:

The retention rate of indocyanine green 15 min after administration

US:

Ultrasonography

CT:

Computed tomography

MRI:

Magnetic resonance imaging

ROI:

Region of interest

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Acknowledgments

The authors wish to thank the technical assistants at the Imaging Center of St. Marianna University School of Medicine Hospital for their assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Hideaki Takahashi, Michihiro Suzuki, Ryuta Shigefuku, Miki Okano, Tetsuya Hiraishi, Rei Takagi, Yohei Noguchi, Nobuhiro Hattori, Moriaki Hatsugai, Kazunari Nakahara, Masaru Okamoto, Minoru Kobayashi, Hiroki Ikeda, Yasunobu Fukuda, Yoshihiko Nagase, Toshiya Ishii, Kotaro Matsunaga, Nobuyuki Matsumoto, Chiaki Okuse & Fumio Itoh

  2. Anzai Medical Company, Ltd, Tokyo, Japan

    Shigeru Sase

  3. Division of Gastroenterology, Department of Internal Medicine, Sapporo Shirakabadai Hospital, Sapporo, Japan

    Hideaki Takahashi

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Correspondence to Hideaki Takahashi.

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Takahashi, H., Suzuki, M., Shigefuku, R. et al. Xenon computed tomography can evaluate the improvement of hepatic hemodynamics before and after endoscopic injection sclerotherapy. J Gastroenterol 48, 1353–1361 (2013). https://doi.org/10.1007/s00535-013-0756-7

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  • DOI: https://doi.org/10.1007/s00535-013-0756-7

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