Virtual non-contrast for evaluation of liver parenchyma and vessels: results from 25 patients using multi-phase spectral-detector CT

2019 ◽  
Vol 61 (8) ◽  
pp. 1143-1152 ◽  
Author(s):  
Kai Roman Laukamp ◽  
Vivian Ho ◽  
Verena Carola Obmann ◽  
Karin Herrmann ◽  
Amit Gupta ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Abdominal Aorta ◽  
Liver Parenchyma ◽  
Image Noise ◽  
Common Hepatic Artery ◽  
Diagnostic Assessment ◽  
Arterial Phase ◽  
Spectral Detector Ct ◽  
Venous Phase

Background In abdominal imaging, contrast-enhanced computed tomography (CT) examinations are most commonly applied; however, unenhanced examinations are still needed for several clinical questions but require additional scanning and radiation exposure. Purpose To evaluate accuracy of virtual non-contrast (VNC) from arterial and venous phase spectral-detector CT (SDCT) scans compared to true-unenhanced (TNC) images for the evaluation of liver parenchyma and vessels. Material and Methods A total of 25 patients undergoing triphasic SDCT examinations were included. VNC was reconstructed from arterial and venous phases and compared to TNC images. Quantitative image analysis was performed by region of interest (ROI)-based assessment of mean and SD of attenuation (HU) in each liver segment, spleen, portal vein, common hepatic artery, and abdominal aorta. Subjectively, iodine subtraction and diagnostic assessment were rated on 5-point Likert scales. Results Attenuation and image noise measured in the liver from VNC were not significantly different from TNC (TNC: 54.6 ± 10.8 HU, VNC arterial phase: 55.7 ± 10.8 HU; VNC venous phase: 58.3 ± 10.0 HU; P > 0.05). VNC also showed accurate results regarding attenuation and image noise for spleen, portal vein, and abdominal aorta. Only iodine subtraction in the common hepatic artery in the arterial phase was insufficient which was confirmed by the subjective reading. Apart from that, subjective reading showed accurate iodine subtraction and comparable diagnostic assessment. Conclusion VNC from the arterial and venous phases were very similar to TNC yielding mostly negligible differences in attenuation, image noise, and diagnostic utility. Inadequate iodine subtraction occurred in hepatic arteries in the arterial phase.

scholarly journals Evaluation of the liver with virtual non-contrast: single institution study in 149 patients undergoing TAVR planning

2020 ◽  
Vol 93 (1106) ◽  
pp. 20190701 ◽  
Author(s):  
Kai Roman Laukamp ◽  
Simon Lennartz ◽  
Vivian Ho ◽  
Nils Große Hokamp ◽  
David Zopfs ◽  
...  
Keyword(s):  
Contrast Media ◽  
Abdominal Aorta ◽  
Region Of Interest ◽  
Hounsfield Unit ◽  
Liver Parenchyma ◽  
Arterial Phase ◽  
Single Institution ◽  
Transcatheter Aortic Valve ◽  
Spectral Detector Ct ◽  
Early Arterial Phase

Objective: To evaluate accuracy of virtual-non-contrast images (VNC) compared to true-unenhanced-images (TNC) for evaluation of liver attenuation acquired using spectral-detector CT (SDCT). Methods: 149 patients who underwent multiphase transcatheter-aortic-valve-replacement (TAVR) SDCT-examinations [unenhanced-chest (TNC), CT-angiography chest (CTA-chest, early arterial-phase) and abdomen (CTA-abdomen, additional early arterial-phase after a second injection of contrast media)] were retrospectively included. VNC of CTA-chest (VNC-chest) and CTA-abdomen (VNC-abdomen) were reconstructed and compared to TNC. Region of interest-based measurement of mean attenuation (Hounsfield unit, HU) was applied in the following regions: liver, spleen, abdominal aorta and paraspinal muscle. Results: VNC accuracy was high in the liver, spleen, abdominal aorta and muscle for abdomen-scanning. For the liver, average attenuation was 59.0 ± 9.1 HU for TNC and 72.6 ± 9.5 HU for CTA-abdomen. Liver attenuation in VNC-abdomen (59.1 ± 6.4 HU) was not significantly different from attenuation in TNC (p > 0.05). In contrast, VNC was less accurate for chest-scanning: Due to the protocol, in CTA-chest no contrast media was present in the liver parenchyma as indicated by the same attenuation in TNC (59.0 ± 9.1 HU) and CTA-chest (58.8 ± 8.9 HU, p > 0.05). Liver attenuation in VNC-chest (56.2 ± 6.4 HU, p < 0.05) was, however, significantly lower than in TNC and CTA-chest implying an artificial reduction of attenuation. Conclusion: VNC performed well in a large cohort of TAVR-examinations yielding equivalent mean attenuations to TNC; however, application of this technique might be limited when no or very little contrast media is present in parenchyma, more precisely in an early arterial-phase of the liver. Advances in knowledge: This study showed that VNC can be reliably applied in cardiac protocols when certain limitations are considered

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

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lei Wang ◽  
Rengui Wang ◽  
Chunyan Zhang ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Equilibrium Phase ◽  
Liver Parenchyma ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Hepatic Parenchyma ◽  
Before And After ◽  
Venous Phase ◽  
Flow Changes

AbstractTo compare changes in spectral CT iodine densities of hepatic parenchyma and vessels before and after transjugular intrahepatic portosystemic shunt (TIPS) in hepatitis B virus (HBV)-related liver cirrhosis. Twenty-five patients with HBV-related liver cirrhosis who received TIPS for gastroesophageal varices bleeding were recruited. Each patient underwent three phases contrast CT before and after TIPS within 4 weeks, with the raw data reconstructed at 1.25-mm-thick slices. Iodine density (in milligrams per milliliter) was measured on iodine-based material decomposition image. Multiple regions of interest (ROIs) in liver parenchyma, aorta and portal vein were selected from three slices of images. Portal vein trunk was set as the central one, and mean liver parenchymal iodine densities from arterial phase (AP), venous phase (VP) and equilibrium phase (EP) were recorded. Quantitative indices of iodine density (ID), including normalized ID in liver parenchyma for arterial phase (NIDLAP), ID of liver parenchyma for venous phase (IDLVP), ID of portal vein in venous phase (IDPVP) and liver arterial iodine density fraction (AIF), were measured and compared before and after TIPS. Based on Child–Pugh stage, 4, 12 and 9 patients were classified as grade A, B, and C, respectively. Liver volume was comparable before and after TIPS (1110.5 ± 287.4 vs. 1092.0 ± 276.3, P = 0.28). After TIPS, ID was decreased in aorta (146.0 ± 34.5 vs. 120.9 ± 30.7, P < 0.01) whereas increased in liver parenchyma at arterial phase, as demonstrated by IDAP (9.3 ± 3.1 vs. 13.4 ± 4.4 mg/mL) and AIF (0.40 ± 0.11 vs. 0.58 ± 0.11, P < 0.01). For venous or equilibrium phase, quantitative indices remained stable (23.1 ± 4.5 vs. 23.0 ± 5.3, 19.8 ± 4.1 vs. 19.4 ± 4.6) mg/mL (Ps > 0.05). For portal vein, ID and NID were increased after TIPS (23.1 ± 11.7 vs. 36.5 ± 13.0, 16.4 ± 8.5 vs. 31.8 ± 12.8) (P < 0.01). No positive correlation between iodine density and preoperative Child–Pugh score was observed. Based on iodine density measurement, spectral CT as a noninvasive imaging modality may assess hepatic parenchyma and vascular blood flow changes before and after TIPS in HBV-related liver cirrhosis.Clinical registration number: ChiCTR- DDC-16009986.

scholarly journals Changes in Spectral CT Iodine Densities before and after TIPS in HBV-related liver cirrhosis: A Preliminary Study

2021 ◽  
Author(s):  
Lei Wang ◽  
Rengui Wang ◽  
Chunyan Zhang ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Equilibrium Phase ◽  
Liver Parenchyma ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Gastroesophageal Varices ◽  
Quantitative Indices ◽  
Before And After ◽  
Venous Phase

Abstract Objectives To compare changes in spectral CT iodine densities of hepatic parenchyma and vessels before and after transjugular intrahepatic portosystemic shunt (TIPS) in hepatitis B virus (HBV)-related liver cirrhosis. Materials and Methods Twenty-five patients with HBV-related liver cirrhosis who received TIPS for gastroesophageal varices bleeding were recruited. Each patient underwent three phases contrast CT before and after TIPS within 4 weeks, with the raw data reconstructed at 1.25-mm-thick slices. Iodine density (in milligrams per milliliter) was measured on iodine-based material decomposition image. Multiple regions of interest (ROIs) in liver parenchyma, aorta and portal vein were selected from three slices of images. Portal vein trunk was set as the central one, and mean liver parenchymal iodine densities from arterial phase (AP), venous phase (VP) and equilibrium phase (EP) were recorded. Quantitative indices of iodine density (ID), including normalized ID in liver parenchyma for arterial phase (NIDLAP), ID of liver parenchyma for venous phase (IDLVP), ID of portal vein in venous phase (IDPVP) and liver arterial iodine density fraction (AIF), were measured and compared before and after TIPS. Results Based on Child-Pugh stage, 4, 12 and 9 patients were classified as grade A, B, and C, respectively. Liver volume was comparable before and after TIPS (1110.5±287.4 vs. 1092.0±276.3, P = 0.28). After TIPS, ID was decreased in aorta (146.0±34.5 vs. 120.9± 30.7, P<0.01) whereas increased in liver parenchyma at arterial phase, as demonstrated by IDAP (9.3±3.1 vs. 13.4±4.4 mg/mL) and AIF (0.40±0.11 vs. 0.58 ± 0.11, P<0.01). For venous or equilibrium phase, quantitative indices remained stable (23.1±4.5 vs. 23.0±5.3, 19.8±4.1 vs. 19.4±4.6) mg/mL (Ps>0.05). For portal vein, ID and NID were increased after TIPS (23.1±11.7 vs. 36.5±13.0, 16.4±8.5 vs. 31.8±12.8) (P<0.01). No positive correlation between iodine density and preoperative Child-Pugh score was observed. Conclusions Based on iodine density measurement, spectral CT as a noninvasive imaging modality may assess hemodynamic changes before and after TIPS in HBV-related liver cirrhosis.

scholarly journals Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Gregory Sergeant ◽  
Erik Schadde ◽  
Geert Maleux ◽  
Raymond Aerts
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Balloon Dilation ◽  
En Bloc Resection ◽  
Common Hepatic Artery ◽  
Pathological Examination ◽  
Periampullary Cancer ◽  
En Bloc ◽  
Head Of The Pancreas ◽  
The Common

A 64-year-old female patient with adenocarcinoma of the head of the pancreas with encasement of the common hepatic artery and portal vein stenosis was reexplored after six cycles of gemcitabine (1000 mg/m2). Prior to surgery, the patient underwent balloon dilation and stenting of the portal vein in addition to successful coil embolisation of the common hepatic artery, proper hepatic artery, and proximal gastroduodenal artery. After embolisation, a pylorus-preserving pancreaticoduodenectomy was performed with resection of the common hepatic artery and portal vein confluens. Pathological examination showed a moderately differentiated pT3N0 (Stage IIa, TNM 7th edition) tumor with negative section margins. We show with this case that in selected cases of periampullary cancer with encasement of the common hepatic artery, it is technically feasible to perform pancreaticoduodenectomy with hepatic artery resection and negative surgical margins. Nevertheless, the oncological benefit of extended arterial resections remains controversial.

Effect of Repeated Normothermic Ischaemia on Normal Liver Parenchyma

1987 ◽  
Vol 28 (2) ◽  
pp. 215-219
Author(s):  
H. Stridbeck ◽  
T. Holmin ◽  
I. Hägerstrand
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Alternative Treatment ◽  
Balloon Catheter ◽  
Normal Liver ◽  
Liver Parenchyma ◽  
Histopathologic Examination ◽  
Liver Tumours ◽  
Small Areas ◽  
Minimal Damage

Hepatic ischaemia was induced in 8 mesenterico-cavally shunted pigs. The hepatic artery was occluded with biodegradable starch microspheres and the portal vein with a balloon catheter. The liver was kept ischaemic for 90 minutes at the beginning, and 90 minutes at the end, of a 24-hour period. At histopathologic examination 6 of the livers had multiple, small areas of necrosis. The total volume of these necroses accounted for no more than 10 to 15 per cent of each liver. No necrosis was evident in 2 livers. Thus normothermic Ischaemia for 2 periods of 90 minutes each within a 24-hour period caused minimal damage to the liver. An alternative treatment in patients with liver tumours could therefore be simultaneous occlusion of the hepatic artery and the portal vein.

scholarly journals Novel surgical technique and efficacy analysis of donor pancreas preparation without vascular reconstruction in pancreas transplantation

2019 ◽  
Vol 47 (12) ◽  
pp. 6182-6191
Author(s):  
Wen-wei Liao ◽  
Xiang-chao Ling ◽  
Cheng Zhang ◽  
Fu-rong Liu ◽  
Xiao-feng Zhu ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Pancreas Transplantation ◽  
Vascular Complications ◽  
Celiac Trunk ◽  
Vascular Reconstruction ◽  
Gastroduodenal Artery ◽  
Common Hepatic Artery ◽  
Efficacy Analysis ◽  
Outflow Channel

Objective Because of the complicated blood supply and vascular structure of the pancreas, blood vessel reconstruction and reshaping are generally required during pancreas transplantation. We modified the vascular preparation procedure for the donor pancreas (i.e., no vascular reconstruction was performed) based on experiences in our department and in other domestic and international transplantation centers. Methods Twelve donor pancreas preparations without vascular reconstruction were performed. The patch (Carrel patch), celiac trunk, and superior mesenteric artery were preserved as arterial inflow channels for the donor pancreas. The common hepatic artery and the gastroduodenal artery were transected at a site 0.5 cm away from the bifurcation. The bifurcated portion was preserved for the donor liver. The stumps of the gastroduodenal artery and common hepatic artery were then ligated. The portal vein was transected in the middle of the hepatoduodenal ligament during separation of the liver and pancreas. The partial portal vein preserved with the pancreas was used as the outflow channel of the donor pancreas. Results The transplanted pancreas functioned well in the recipients, and no vascular complications were reported. Conclusion The overall efficacy of pancreas transplantation without vascular reconstruction has been improved.

Disappearance Rate of 133Xe from the Dog Liver with Different Routes of Administration

1968 ◽  
Vol 07 (02) ◽  
pp. 119-124
Author(s):  
K. F. Aronsen ◽  
B. Ericsson ◽  
S. E. Lindell ◽  
G. Nylander
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Liver Parenchyma ◽  
Disappearance Rate ◽  
Routes Of Administration ◽  
Dog Liver

SummaryIn anaesthetized dogs the disappearance rate of 133Xe injected into the liver parenchyma was much slower than that of 133Xe injected into the hepatic artery, while the highest disappearance rate was obtained when the isotope was injected into the portal vein. Vasopressin reduced the disappearance rate of 133Xe injected into the portal vein considerably without changing the disappearance rates for the isotope injected into the hepatic artery or directly into the liver parenchyma.

Penetrating Traumatic Laceration of Common Hepatic Artery and Portal Vein: A Rare Story of Success

2017 ◽  
Vol 83 (5) ◽  
pp. 148-150
Author(s):  
Paula Ferrada ◽  
Asanthi Ratnasekera ◽  
Amna Khokar
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Common Hepatic Artery
Sign in / Sign up

Export Citation Format

Share Document