Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Kanagawa, Japan.
Int J Mol Sci. 2014 Jan 14;15(1):1026-39. doi: 10.3390/ijms15011026.
The present study evaluated the utility of xenon computed tomography (Xe-CT) as a noninvasive diagnostic procedure for the measurement of hepatic tissue blood flow (TBF) in patients with nonalcoholic fatty liver disease (NAFLD) or chronic hepatitis C (CH-C).
Xe-CT was performed in 93 patients with NAFLD and in 109 patients with CH-C. Subjects were classified into one of three groups, based on fibrosis stage: group 1, no bridging fibrosis; group 2, bridging fibrosis; and group 3, liver cirrhosis. Correlations between hepatic TBFs in each fibrosis stage were examined.
In group 1, portal venous TBF (PVTBF), hepatic arterial (HATBF), and total hepatic TBF (THTBF) were significantly lower in patients with in nonalcoholic steatohepatitis (NASH) than in those with CH-C (p < 0.001, p < 0.05, p < 0.001, respectively). In group 2, PVTBF and THTBF were significantly lower in patients with in NASH than in those with CH-C (p < 0.001, p < 0.05, respectively). In group 3, hepatic TBFs were not significantly different when comparing patients with NASH and those with CH-C.
PVTBF decreased due to fat infiltration. Therefore, hemodynamic changes occur relatively earlier in NAFLD than in CH-C. Patients with NASH should be monitored carefully for portal hypertensive complications in the early fibrosis stage.
本研究评估氙气计算机断层扫描（Xe-CT）作为一种非侵入性诊断程序，用于测量非酒精性脂肪性肝病（NAFLD）或慢性丙型肝炎（CH-C）患者的肝组织血流（TBF）。
对 93 例 NAFLD 患者和 109 例 CH-C 患者进行了 Xe-CT 检查。根据纤维化分期，将受试者分为三组：组 1，无桥接纤维化；组 2，桥接纤维化；组 3，肝硬化。检查了每个纤维化阶段的肝 TBF 之间的相关性。
在组 1 中，门脉 TBF（PVTBF）、肝动脉（HATBF）和总肝 TBF（THTBF）在非酒精性脂肪性肝炎（NASH）患者中明显低于 CH-C 患者（p < 0.001，p < 0.05，p < 0.001，分别）。在组 2 中，PVTBF 和 THTBF 在 NASH 患者中明显低于 CH-C 患者（p < 0.001，p < 0.05，分别）。在组 3 中，NASH 和 CH-C 患者的肝 TBF 无显著差异。
由于脂肪浸润，PVTBF 降低。因此，NAFLD 的血流动力学变化发生得比 CH-C 更早。在早期纤维化阶段，应密切监测 NASH 患者发生门静脉高压并发症的风险。
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