Assessment of liver fibrosis in the early stages with perfusion CT.

OBJECTIVES

This work aims to assess the feasibility of perfusion CT in diagnosis of liver fibrosis in the early stage.

MATERIALS AND METHODS

Solutions of carbon tetrachloride (CCL4) were injected into the peritoneum of 45 rabbits to establish rabbit models of liver fibrosis. Perfusion CT were performed at 4-, 8-, 12- and 16- week after injection. The parametric perfusion indices of blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) on perfusion maps were measured. Liver samples were scored as F0, F1, F2, F3, F4 for fibrosis.

RESULTS

In 50 rabbits, 23 rabbits survived. Of these survival rabbits, 5 rabbits were histopathologically scored as F0, 7 rabbits were F1, 8 rabbits were F2, and 3 rabbits were F3. For relatively small number of F3, multiple comparisons were made for F0 vs. F1, F1 vs. F2 and F0 vs. F2. A statistically significant difference was observed in PVP, BV, BF, ALP and HPI between F1 vs. F2 and F0 vs. F2, whereas a significant statistical difference was only achieved in PVP between F0 vs. F1. In the early stage of liver fibrosis PVP decreased with the progression of liver fibrosis, whereas HPI, ALP and BF increased with the progression of liver fibrosis. BV had no marked change.

CONCLUSIONS

Perfusion CT is feasible in diagnosis of early stage of liver fibrosis. PVP appears to be the most promising parametric perfusion index.