The Diagnosis Of Hepatic Perfusion Disorders With Multi-Slice Spiral CT

Objective To evaluate the various patterns of hepatic perfusion disorders with multi-slice spiral CT and to emphasize the significance of recognition for them . Methods In a period of 1 year, the all CT images of 1568 patients received multi-slice spiral CT examination of upper abdomen were analyzed retrospectively. The etiologies and mechanisms of different pattens of hepatic perfusion disorders were investigated. Results 103 cases were demonstrated to have hepatic perfusion disorders. 67 cases were associated with tumors and the other 34 cases were non-tumor associated. The etiologies of various hepatic perfusion disorders were classified as (1), arterioportal fistulae(41.7%), (2) portal venous inflow obstruction(23.3%), (3) inflammartory hyperemic changes(17.5%), (4) steal phenomenon by hypervascular tumors(6.8%), (5) hepatic venous outflow obstruction(4.9%), (6) aberrant hepatic blood supply (3.9%) and (7) uncertain causes(1.9%). The mechanisms of most hepatic perfusion disorders can be explained with redistributing hepatic arterial flow and resulting in an arterioportal shunt(APS) caused by various conditions. Conclusion Multi-slice spiral CT provides a new effective technique for demonstrating and understanding various hepaticperfusion disorders. Familiarity with the helical CT appearances of these perfusion disorders will result in more accurate evaluation for various pathologic or physiologic states reflected by them.