Published online Nov 14, 2022. doi: 10.3748/wjg.v28.i42.6068
Peer-review started: August 7, 2022
First decision: August 31, 2022
Revised: October 14, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 14, 2022
Hepatic venous pressure gradient (HVPG) is the gold standard for diagnosis of portal hypertension (PH), but the measurement of HVPG is an invasive procedure, which has limited its widespread use. Therefore, we aimed to investigate the feasibility of computed tomography (CT) perfusion as a non-invasive imaging tool for HVPG in PH.
To date, no satisfactory non-invasive method has been proposed as an alternative for HVPG. Determining the feasibility of CT perfusion indices as a non-invasive tool to assess HVPG would be beneficial to patients.
To investigate the correlation of CT perfusion of the liver with HVPG and Child-Pugh score in hepatitis B virus (HBV)-related PH.
We prospectively selected 28 HBV-related PH patients in our hospital from January 2019 to June 2019. CT perfusion was performed in all patients, and quantitative parameters of CT perfusion were applied to evaluate HVPG non-invasively. Quantitative indices, including liver blood volume (LBV), liver blood flow (LBF), hepatic artery fraction, splenic blood volume and splenic blood flow, were calculated. The correlation analysis was calculated, and receiver operating characteristic curve analysis was performed.
Quantitative parameters of CT perfusion imaging, in particular LBV and LBF, were negatively correlated with HVPG and Child-Pugh scores.
Our findings showed that CT perfusion parameters, LBV and LBF, were negatively correlated with HVPG and Child-Pugh scores. CT perfusion imaging showed potential as a non-invasive quantitative method for the evaluation of HVPG in HBV-related PH.
Non-invasive assessment of HVPG has been an area of interest for decades, and multi-modality research should be explored in the future, including CT perfusion, anatomical information, lab results, liver and spleen stiffness and computation simulation modeling.