Clinical Trials Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2022; 28(42): 6068-6077
Published online Nov 14, 2022. doi: 10.3748/wjg.v28.i42.6068
Computed tomography perfusion in liver and spleen for hepatitis B virus-related portal hypertension: A correlation study with hepatic venous pressure gradient
Lei Wang, Yu Zhang, Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Chun-Yan Zhang, Fu-Quan Liu, Jian Dong
Lei Wang, Department of Intervention Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Yu Zhang, Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Fu-Quan Liu, Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Chun-Yan Zhang, Jian Dong, Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Author contributions: Dong J, Liu FQ, and Wang L designed the report; Zhang Y, Wu YF, Yue ZD, Fan ZH, and Zhang CY collected the clinical data; Wang L and Zhang Y analyzed and wrote the paper; Dong J and Liu FQ performed quality control; Liu FQ contributed to administrative and financial support; all authors have read and approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China General Program, No. 81871461.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Beijing Shijitan Hospital, Capital Medical University (Approval No. 201801).
Clinical trial registration statement: This study is registered at ClinicalTrials.gov: http://www.chictr.org.cn/edit.aspx?pid=26048&htm=4. The registration identification number is ChiCTR1800015268.
Informed consent statement: Written informed consent was obtained from each patient.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Dong, MD, Doctor, Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Street, Haidian District, Beijing 100038, China. dongjianradiology@163.com
Received: August 7, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To investigate the correlation of CT perfusion of the liver with HVPG and Child-Pugh score in hepatitis B virus (HBV)-related PH.

Research methods

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.

Research results

Quantitative parameters of CT perfusion imaging, in particular LBV and LBF, were negatively correlated with HVPG and Child-Pugh scores.

Research conclusions

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.

Research perspectives

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.