The Application Value Of Liver CT Perfusion-like Imaging Before And After TIPS In Patients With Liver Cirrhosis PHT

Objective:To investigate the feasibility of CT perfusion imaging in patients with liver cirrhosis and portal hypertension(PHT)before and after TIPS,the changes of perfusion parameters and its evaluation value in the curative effect of TIPs,as well as the changes of liver function after TIPS.Methods:From January 2016 to January 2018,30 PHT patients with viral hepatitis cirrhosis who underwent TIPS in the first Hospital of Lanzhou University were analyzed retrospectively.there were 15 males and 15 females,including 15 males and15 females,within 1 week before operation and 4 weeks after operation.Age 50.2±12.3 years;27 cases of hepatitis B,3 cases of hepatitis C;25 cases of upper gastrointestinal bleeding,5 cases of ascites.Firstly,hepatic artery perfusion(HAP),portal vein perfusion(PVP),arterial perfusion index(HPI)and arterial enhancement fraction(AEF);were calculated by software before and after TIPS.The patients were divided into effective group(n = 25)and ineffective group(n = 5).The AEF values of each group were calculated respectively.serological examinations were collected before and after operation to calculate the(MELD)score of end-stage liver disease.Finally,the difference between the parameters was analyzed statistically,P < 0.05,the difference was statistically significant.Results:1.The changes of hepatic perfusion-like parameters after operation: the increase of HAP,HPI and AEF after operation was statistically significant,but the decrease after operation was not statistically significant.2.Evaluation of curative effect: the value of AEF in the effective group was higher than that in the ineffective group,which was statistically significant.The sensitivity and specificity were 60% and 100% respectively,and the area under thecurve(AUC)was 0.816(P < 0.001).The critical value of AEF was 0.501 to predict the short-term curative effect of TIPS.3.The postoperative MELD score was significantly higher than that before operation,but the MELD in the effective group was slightly lower than that in the ineffective group,and there was no statistical significance.Conclusion:1.Hepatic CT perfusion-like imaging is simple and easy to perform,which can reflect the change trend of hepatic microcirculation before and after TIPS with PHT,that is,HAP and HPI increase and PVP decreases after operation;2.AEF value can be used to qualitatively evaluate the short-term efficacy of TIPS after PHT treatment3.Liver function continues to deteriorate in the short term after TIPS.