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Clinical Efficacy of Spectral Computed Tomography for Evaluating Liver Function in Patients with Budd–Chiari Syndrome

医学 肝功能 布加综合征 胃肠病学 内科学 肝功能检查 凝血酶原时间 白蛋白 胆红素 计算机断层摄影术 核医学 丙氨酸转氨酶 放射科 下腔静脉
作者
Lei Su,Lin Hu,Pan Liang,Yan Wu,Qiang Sun,Jianbo Gao
出处
期刊:Academic Radiology [Elsevier]
卷期号:26 (4): 461-466 被引量:7
标识
DOI:10.1016/j.acra.2018.05.003
摘要

Rationale and Objectives To analyze the clinical relevance of quantitative spectral parameters in evaluating the treatment of patients with Budd–Chiari syndrome (BCS) with different classes of liver function by comparing normalized iodine concentration (NIC) before and after BCS treatment. Materials and Methods Angiographic data were obtained from 41 patients with confirmed BCS between December 2015 and March 2017. All patients underwent spectral computed tomography (CT) before and after BCS treatment; the average interval between scans was 2–4 months. Iodine concentration and NIC were measured and calculated during the portal venous phase in liver segments I–VIII. Clinical liver function parameters including prothrombin time (PT), albumin (ALB), total bilirubin (TBIL), aspartate aminotransferase, and alanineaminotransferase were recorded. Liver function was classified according to the Child–Pugh grading standard (before treatment). Liver NIC and liver function-related parameters before and after treatment were compared using the paired t-test; Pearson correlation analysiswas performed to analyze the aforementioned parameters among different liver function classes before BCS treatment. p < 0.05 was to be statistically considered significant. Results PT and TBIL were negatively correlated with liver NIC (p < 0.05), whereas ALB and liver NIC exhibited a positive correlation (p < 0.05). Comparison of NIC before and after treatment revealed that NIC in liver segments I–VIII was higher after treatment. The p values for segments II–VIII were 0.041, 0.046, 0.041, 0.038, 0.039, 0.042, and 0.040, respectively; the differences were statistically significant (p < 0.05). The increase in NIC in liver segments I–VIII before and after treatment was more significant in patients with class C liver function than in their class B and A counterparts. Comparison of liver function-related parameters revealed that PT was shortened after treatment; ALB levels were increased; and TBIL, alanine aminotransferase, and aspartate aminotransferase levels were decreased. Conclusion NIC determined through spectral CT was beneficial for evaluating liver function in patients with BCS, and can provide imaging data for reexamination, prognostic evaluation, and follow-up of patients with BCS after treatment. Liver parenchyma NIC values in BCS patients with varying liver function may provide a degree of diagnostic value. Multi-locus and multi-parameter studies of spectral CT can help to further evaluate liver function and assess prognosis in patients with BCS. To analyze the clinical relevance of quantitative spectral parameters in evaluating the treatment of patients with Budd–Chiari syndrome (BCS) with different classes of liver function by comparing normalized iodine concentration (NIC) before and after BCS treatment. Angiographic data were obtained from 41 patients with confirmed BCS between December 2015 and March 2017. All patients underwent spectral computed tomography (CT) before and after BCS treatment; the average interval between scans was 2–4 months. Iodine concentration and NIC were measured and calculated during the portal venous phase in liver segments I–VIII. Clinical liver function parameters including prothrombin time (PT), albumin (ALB), total bilirubin (TBIL), aspartate aminotransferase, and alanineaminotransferase were recorded. Liver function was classified according to the Child–Pugh grading standard (before treatment). Liver NIC and liver function-related parameters before and after treatment were compared using the paired t-test; Pearson correlation analysiswas performed to analyze the aforementioned parameters among different liver function classes before BCS treatment. p < 0.05 was to be statistically considered significant. PT and TBIL were negatively correlated with liver NIC (p < 0.05), whereas ALB and liver NIC exhibited a positive correlation (p < 0.05). Comparison of NIC before and after treatment revealed that NIC in liver segments I–VIII was higher after treatment. The p values for segments II–VIII were 0.041, 0.046, 0.041, 0.038, 0.039, 0.042, and 0.040, respectively; the differences were statistically significant (p < 0.05). The increase in NIC in liver segments I–VIII before and after treatment was more significant in patients with class C liver function than in their class B and A counterparts. Comparison of liver function-related parameters revealed that PT was shortened after treatment; ALB levels were increased; and TBIL, alanine aminotransferase, and aspartate aminotransferase levels were decreased. NIC determined through spectral CT was beneficial for evaluating liver function in patients with BCS, and can provide imaging data for reexamination, prognostic evaluation, and follow-up of patients with BCS after treatment. Liver parenchyma NIC values in BCS patients with varying liver function may provide a degree of diagnostic value. Multi-locus and multi-parameter studies of spectral CT can help to further evaluate liver function and assess prognosis in patients with BCS.
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