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

• Published in: Journal of gastroenterology Vol. 48; no. 12; pp. 1353 - 1361
• Main Authors: Takahashi, Hideaki, Suzuki, Michihiro, Shigefuku, Ryuta, Okano, Miki, Hiraishi, Tetsuya, Takagi, Rei, Noguchi, Yohei, Hattori, Nobuhiro, Hatsugai, Moriaki, Nakahara, Kazunari, Okamoto, Masaru, Kobayashi, Minoru, Ikeda, Hiroki, Fukuda, Yasunobu, Nagase, Yoshihiko, Ishii, Toshiya, Matsunaga, Kotaro, Matsumoto, Nobuyuki, Okuse, Chiaki, Sase, Shigeru, Itoh, Fumio
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2013; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Biliary Tract; Colorectal Surgery; CT imaging; Endoscopy - methods; Esophageal and Gastric Varices - pathology; Esophageal and Gastric Varices - therapy; Female; Gastroenterology; Hepatic Artery - metabolism; Hepatitis B; Hepatitis C virus; Hepatology; Humans; Liver; Liver - blood supply; Liver - pathology; Liver cirrhosis; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article—Liver; Pancreas; Portal Vein - metabolism; Prospective Studies; Regional Blood Flow; Sclerotherapy - methods; Surgical Oncology; Tomography, X-Ray Computed - methods; Xenon; Sclerotherapy; Hepatic tissue blood flow; Portal hypertension; Xe computed tomography
• ISSN: 0944-1174; 1435-5922; 1435-5922
• DOI: 10.1007/s00535-013-0756-7

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.