Hepatic Perfusion Parameters in Chronic Liver Disease
Dynamic CT Measurements Correlated with Disease Severity
Bernard E. Van Beers1,
Isabelle Leconte1,
Roland Materne1,
Anne M. Smith1,
Jacques Jamart2 and
Yves Horsmans3
1
Department of Radiology, Université Catholique
de Louvain, St-Luc University Hospital, Ave. Hippocrate 10, B-1200 Brussels,
Belgium.
2
Center of Biostatistics and Medical Documentation,
Université Catholique de Louvain, Mont-Godinne
University Hospital, Ave. Thérasse 1, B-5530
Yvoir, Belgium.
3
Laboratory of Gastroenterology, Université
Catholique de Louvain, St-Luc University Hospital, B-1200 Brussels,
Belgium.
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Fig. 1A. —79-year-old woman without liver disease (control subject).
Graph shows time—density curves of aorta (solid line), portal
vein (long dashes), and liver (short dashes).
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Fig. 1B. —79-year-old woman without liver disease (control subject).
Graph of corresponding best-fit curve shows hepatic signal increase
(dots) and fit (solid line).
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Fig. 1C. —79-year-old woman without liver disease (control subject).
Dynamic single-section CT scan shows typical level that includes liver, aorta,
and portal vein.
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Fig. 2A. —Time—density curves in 40-year-old woman with
Child-Pugh classification B cirrhosis. Graph shows time-density curves of
aorta (solid line), portal vein (long dashes), and liver
(short dashes). Note lower peak signal increase in portal vein in
this patient than in control subject shown in
Figure 1A.
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Fig. 2B. —Time—density curves in 40-year-old woman with
Child-Pugh classification B cirrhosis. Graph of corresponding best-fit curve
shows hepatic signal increase (dots) and fit (solid
line).
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Fig. 3A. —Box plots of group perfusion parameters in which boundary of
boxes closest to zero indicates 25th percentile, line within boxes marks
median, and boundary of boxes farthest from zero indicates 75th percentile.
Error bars below and above boxes indicate 10th and 90th percentiles. Outliers
are represented as individual points. A-D, Graphs show box plots of
liver perfusion (A), arterial fraction (B), distribution volume
(C), and mean transit time (D). Liver perfusion is significantly
decreased, and arterial fraction and mean transit time are significantly
increased in cirrhotic group relative to control group and group with
noncirrhotic chronic liver disease. In D, one outlier has not been
represented in cirrhotic group to maintain clarity of graph.
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Fig. 3B. —Box plots of group perfusion parameters in which boundary of
boxes closest to zero indicates 25th percentile, line within boxes marks
median, and boundary of boxes farthest from zero indicates 75th percentile.
Error bars below and above boxes indicate 10th and 90th percentiles. Outliers
are represented as individual points. A-D, Graphs show box plots of
liver perfusion (A), arterial fraction (B), distribution volume
(C), and mean transit time (D). Liver perfusion is significantly
decreased, and arterial fraction and mean transit time are significantly
increased in cirrhotic group relative to control group and group with
noncirrhotic chronic liver disease. In D, one outlier has not been
represented in cirrhotic group to maintain clarity of graph.
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Fig. 3C. —Box plots of group perfusion parameters in which boundary of
boxes closest to zero indicates 25th percentile, line within boxes marks
median, and boundary of boxes farthest from zero indicates 75th percentile.
Error bars below and above boxes indicate 10th and 90th percentiles. Outliers
are represented as individual points. A-D, Graphs show box plots of
liver perfusion (A), arterial fraction (B), distribution volume
(C), and mean transit time (D). Liver perfusion is significantly
decreased, and arterial fraction and mean transit time are significantly
increased in cirrhotic group relative to control group and group with
noncirrhotic chronic liver disease. In D, one outlier has not been
represented in cirrhotic group to maintain clarity of graph.
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Fig. 3D. —Box plots of group perfusion parameters in which boundary of
boxes closest to zero indicates 25th percentile, line within boxes marks
median, and boundary of boxes farthest from zero indicates 75th percentile.
Error bars below and above boxes indicate 10th and 90th percentiles. Outliers
are represented as individual points. A-D, Graphs show box plots of
liver perfusion (A), arterial fraction (B), distribution volume
(C), and mean transit time (D). Liver perfusion is significantly
decreased, and arterial fraction and mean transit time are significantly
increased in cirrhotic group relative to control group and group with
noncirrhotic chronic liver disease. In D, one outlier has not been
represented in cirrhotic group to maintain clarity of graph.
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Fig. 4. —Graph shows receiver operating characteristic (ROC) curves
for values of liver perfusion (solid line), arterial fraction
(dotted line), and mean transit time (dashed line) used in
diagnosing cirrhosis. We found no statistically significant difference in area
under three ROC curves (liver perfusion, 0.81 ± 0.07; arterial
fraction, 0.78 ± 0.08; mean transit time, 0.89 ± 0.05;
p > 0.1), indicating no significant difference in accuracy of
these three perfusion parameters when diagnosing cirrhosis.
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Copyright © 2001 by the American Roentgen Ray Society.
