Hepatic parenchyma and vascular blood flow changes after TIPS with spectral CT iodine density in HBV-related liver cirrhosis

Spectral CT: Current Liver Applications

Using two different energy levels, dual-energy computed tomography (DECT) allows for material differentiation, improves image quality and iodine conspicuity, and allows researchers the opportunity to determine iodine contrast and radiation dose reduction. Several commercialized platforms with different acquisition techniques are constantly being improved. Furthermore, DECT clinical applications and advantages are continually being reported in a wide range of diseases. We aimed to review the current applications of and challenges in using DECT in the treatment of liver diseases. The greater contrast provided by low-energy reconstructed images and the capability of iodine quantification have been mostly valuable for lesion detection and characterization, accurate staging, treatment response assessment, and thrombi characterization. Material decomposition techniques allow for the non-invasive quantification of fat/iron deposition and fibrosis. Reduced image quality with larger body sizes, cross-vendor and scanner variability, and long reconstruction time are among the limitations of DECT. Promising techniques for improving image quality with lower radiation dose include the deep learning imaging reconstruction method and novel spectral photon-counting computed tomography.

The Relationship and Changes of Liver Blood Supply, Portal Pressure Gradient, and Liver Volume following TIPS in Cirrhosis

AIM

Transjugular intrahepatic portosystemic shunt (TIPS) alters the liver blood supply and reduces portal pressure. This study was to investigate the changes and associations of the hepatic blood flow, liver volume, and portal pressure gradient (PPG) after TIPS in liver cirrhosis.

METHODS

Twenty-one patients with liver cirrhosis who received TIPS were recruited. The contrast CT images were used to assess the iodine density (ID) of liver parenchymal and liver volume. The ID of the liver parenchyma was used to reflect hepatic blood flow. We used a paired t-test and regression analysis to investigate the effect of TIPS on hepatic blood flow, liver volume, and PPG in individuals with cirrhosis and the factors that affect changes in liver volume.

RESULTS

After TIPS, there was a significant improvement in the ID of liver parenchyma at arterial phase (AP) and PPG in individuals with cirrhosis (P < 0.05). Each 1 unit increase in the ID change of whole liver parenchyma at the venous phase (VP) was significantly associated with a 269.44 cm³ increase in the liver volume after TIPS (b = 269.44, P = 0.012). With an increasing ID change of whole liver parenchyma at VP, the change in liver volume followed an increasing trend (P for overall association = 0.005).

CONCLUSIONS

Our data indicate that there was a significant improvement in hepatic blood flow, especially at AP, after TIPS and the change in hepatic blood supply from the portal vein is positively associated with the change in liver volume after TIPS. Increasing the blood supply to the liver from the portal vein may improve the reduction of liver volume.

Correlation with Spectral CT Imaging Parameters and Occult Lymph Nodes Metastases in Sufferers with Isolated Lung Adenocarcinoma

For investigating the correlation with spectral CT imaging parameters and occult lymph nodes metastasis in sufferers with isolated lung adenocarcinoma. The clinic cases data of 352 sufferers with isolated lung adenocarcinoma from January 2019 to January 2022 were assembled. In line with whether the sufferers had occult lymph nodes metastasis, they were taken as a part in the metastasis group (n = 172) and the nonmetastasis group. All sufferers were scanned by spectral CT with a dual-phase contrast-enhanced method, and the recording of spectral CT imaging parameters in arteriovenous phase, iodine concentration (IC), water concentration (WC), the slope rate of the spectral HU curve (λHU), the normalized iodine concentration(NIC), the normalized water concentration(NWC), the normalized effective atomic number (Neff-Z)], and receiver operating characteristic (ROC) were employed to analyze the spectral CT imaging parameters of the arteriovenous phase. Evaluation of occult lymph nodes metastases in sufferers with isolated lung adenocarcinoma. The IC, NIC, λHU, and Neff-Z in the arteriovenous phase spectral CT imaging parameters of the metastasis group were obviously smaller than that of the nonmetastasis group, and the discrepancies were statistically obvious (P < 0.05). The results of ROC curve analysis manifested that the area under the curve (AUC) of λHU, IC, NIC, and Neff-Z in the CT parameters of the arterial phase were 0. 840 (95%CI : 0. 796-0.883), 0.763 (95% CI : 0.708-0.818), 0.918 (95% CI : 0.888-0.948), 0.778 (95% CI : 0.731-0.826). The AUCs of λHU, IC, NIC, and Neff-Z in the venous phase spectral CT parameters were 0.909 (95% CI : 0.877-0.941), 0.837 (95% CI : 0.792-0.881), and 0.980 (95% CI : 0.968-0.968), respectively. 0.993), 0.792 (95% CI : 0.742∼0.842). Spectral CT imaging parameters have a certain value in evaluating occult lymph nodes metastasis in sufferers with isolated lung adenocarcinoma, which is helpful for doctors to judge the lymph nodes metastasis in sufferers with this disease before surgery.