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Erschienen in:
13.05.2017 | Original Article
Changes in liver perfusion and function before and after percutaneous occlusion of spontaneous portosystemic shunt
Erschienen in: Japanese Journal of Radiology | Ausgabe 7/2017
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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.