5 years ago

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

Rudolf Stauber, Daniela Kniepeiss, Silvia Schaffellner, Helmut Mueller, Franz Quehenberger, Helmut Schoellnast, Emina Talakić



To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis.


Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated.


The Spearman correlation coefficient was −0.53 (p < 0.05) between SAF and HVPG, and −0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG.


CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension.

Key points

SAF and SCL are statistically significantly correlated with HVPG

SCL showed stronger correlation with HVPG than SAF

125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH

HAF, PVF and HPI showed no statistically significant correlation with HVPG

Publisher URL: https://link.springer.com/article/10.1007/s00330-017-4788-x

DOI: 10.1007/s00330-017-4788-x

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