HEPATIC PERFUSION AFTER LIVER-TRANSPLANTATION - NONINVASIVE MEASUREMENT WITH DYNAMIC SINGLE-SECTION CT

PURPOSE: To compare hepatic perfusion values after orthotopic liver tr ansplantation with those in healthy volunteers. MATERIALS AND METHODS: Dynamic single-section computed tomography (CT) of the liver performe d in 50 participants, including 30 study patients who had undergone or thotopic liver transplantation and had no clinical evidence of postope rative complications (mean age, 53.7 years) and 20 healthy volunteers (control subjects) (mean age, 59.0 years). CT scans were obtained ata single level to include the liver, spleen, aorta, and portal vein. Sca ns were obtained over 88 seconds (one baseline scan followed by 16 sca ns every 2 seconds and, then, eight scans every 7 seconds) beginning w ith the injection of 40 mL of contrast agent (flow rate, 10 mL/sec). O n each CT scan, the attenuation of these organs was measured in region s of interest to provide time-attenuation curves. From these data the arterial, portal venous, and total perfusion of the liver were calcula ted, and the hepatic perfusion index was assessed. RESULTS: In control subjects and study patients, respectively, mean arterial hepatic perf usion was 0.16 and 0.25 mL/min/mL (P = .001 [two-tailed paired Student t test]), mean portal venous perfusion was 1.22 and 1.26 mL/min/mL, m ean total liver perfusion was 1.38 and 1.50 mL/min/mL (difference not significant), and the mean hepatic perfusion index was 0.12 and 0.16 ( P = .002). CONCLUSION: Arterial hepatic perfusion was significantly in creased after orthotopic liver transplantation, but differences in por tal venous and total liver perfusion were not significant. Dynamic sin gle-section CT might also help evaluate hepatic vascular complications , chronic transplant rejection, and hepatic perfusion in liver cirrhos is.