Preview

Medical alphabet

Advanced search

Diagnostic role of ASL-perfusion of liver in magnetic resonance imaging in assessing risk of developing portal hypertension in patients with viral hepatitis

https://doi.org/10.33667/2078-5631-2021-20-38-43

Abstract

Objective. To establish the diagnostic role of ASL-perfusion of the liver in magnetic resonance imaging (MRI) in assessing the risk of portal hypertension in patients with viral hepatitis.

Materials and methods. 109 patients with viral hepatitis were examined, including 69 (63.3 %) men and 40 (36.7 %) women, the average age of patients was 49.0 ± 2.3 years. All subjects (n = 109) underwent abdominal ultrasound with doppler vascular examination and clinical elastography, ASL-perfusion of the liver with MRI with an assessment of the volume of hepatic blood flow (HBF, ml/100 g/min).

Results. The highest diagnostic and prognostic significance of ASL-perfusion for the liver is a targeted study of changes in the right lobe: for the right lobe, AUROC = 0.886 (95 % CI: 0.799–0.889); for the left, AUROC = 0.635 (95 % CI 0.627–0.641). The diagnostic and prognostic significance of ASLperfusion was evaluated in comparison with ultrasound with doppler vascular examination: AUROC = 0.991 (95 % CI: 0.880–0.993); AUROC = 0.801 (95 % CI: 0.776–0.804), respectively. The quantitative and qualitative characteristics of ASL – liver perfusion were evaluated.

Conclusion. When performing ASL-perfusion of the liver, MRI should evaluate quantitative and qualitative criteria. Criteria for the prognosis of portal hypertension according to ASL- perfusion in MRI in patients with viral hepatitis: HBF 131–160 ml/100 g /min, red card – very high risk, HBF = 161–185 ml/100 g/min, red card – high, HBF = 40–130 ml/100 g/min, mixed card – medium; HBF = 131–160 ml/100 g/min, blue card-low risk (r = 0.883).

About the Authors

E. N. Simakina
Smolensk State Medical University
Russian Federation

Simakina Elena N., assistant of Department of Infectious Diseases with a course of epidemiology

Smolensk



T. G. Morozova
Smolensk State Medical University
Russian Federation

Morozova Tatyana G., MD, Head of the Department of Radiation Diagnostics and Radiation Therapy

Smolensk



References

1. Patlusov E. P., Lopukhov P.D. Combination of chronic hepatitis С and non-alcoholic fatty liver disease. Infectious diseases. 2019; 17 (2): 20–24. https://doi.org/10.20953/1729–9225–2019–2–20–24 (in Russian).

2. World Нealth organization: resolution of the 63rd World Health Assembly on Viral Hepatitis (WHA63.18); 2010 [accessed 5Aug 2018]. Available at: http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_R18-ru.pdf (In Russia).

3. WHO. Global hepatitis report, 2017. 83 p.

4. Johnson S.P, Ramasawmy R, Campbell-Washburn A.E, Wells J., Robson M., Rajkumar V., Lythgoe M.F, Pedley R.B, Walker-Samuel S. Acute changes in liver tumour perfusion measured non-invasively with arterial spin labelling. British Journal of Cancer. 2016; 114 (8): 897–904. https://doi.org/10.1038/bjc.2016.51

5. Schiff Eugene R., Sorrel Michael F., Maddrey Willis S. Cirrhosis of the liver and its complications. Liver transplantation. M.: GEOTAR-Media, 2012. 592 p. (in Russian).

6. Trufanov G. E., Fokin V. A., Asaturyan E. G., Еfimtsev А. Yu., Shmedyk N. Yu., Mashchenko I. A., Chegina D. S., Aldatov R. Kh. Arterial spin labeling: сlinical applications. REJR2019; 9 (4): 129–147. https://doi.org/10.21569/2222–7415–2019–9–4–129–147 (in Russian).

7. Batalov A.I., Zakharova N.E., Pogosbekyan E. L., Fadeyeva L.M., Goryaynov S.A., Bayev A.A., Shults E.I., Chelushkin D.M., Potapov A.A., Pronin I.N. Non-contrast ASL-perfusion in preoperative diagnosis of supratentorial gliomas. Questions of neurosurgery them. N.N. Burdenko. 2018; 82 (6): 15–22. https://doi.org/10.17116/neiro20188206115 (in Russian).

8. Kalchev E., Georgiev R., Balev B. Arterial spin labeling MRI – clinical applications. Varna Medical Forum. 2019; 6 (2): 28–32.

9. Stanzhevskiy A.A., Tyutin L.A. The role of perfusion MRI and CT technology in the hemodynamic evaluation of brain tumors. Translational Medicine. 2015; (4): 41–47. https://doi.org/10.18705/2311–4495–2015–0–4–41–47 (in Russian).

10. Trufanov G. E., Fokin V. A., Asaturyan E. G., Еfimtsev А. Yu., Chegina D. S., Levchuk A. G., Baev M. S., Romanov G. G. Arterial spin labeling: physiсal fundamentals and general questions. REJR 2019; 9 (3): 190–200. https://doi.org/10.21569/2222–7415–2019–9–3–190–200 (in Russian).

11. Barajas RF Jr, Chang JS, Segal MR et al. Differentiation of recurrent glioblastoma multiforme from radiation necrosis after external beam radiation therapy with dynamic susceptibilityweighted contrast-enhanced perfusion MR imaging. Radiology. 2009; 253: 486–496. https://doi.org/10.1148/radiol.2532090007

12. Deibler AR, Pollock JM, Kraft RA, et al. Arterial spin-labeling in routine clinical practice, Part 2: Hypoperfusion patterns. AJNR Am J Neuroradiol. 2008; 29: 1235–41. https://doi.org/10.3174/ajnr.a1033

13. Kim HS, Kim SY. A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. AJNR Am J Neuroradiol. 2007; 28: 1693–99. https://doi.org/10.3174/ajnr.a0674

14. Differential diagnosis of chronic hepatitis: a textbook. O. V. Ryzhkova. Irkutsk, 2020. 62 p. (in Russian).


Review

For citations:


Simakina E.N., Morozova T.G. Diagnostic role of ASL-perfusion of liver in magnetic resonance imaging in assessing risk of developing portal hypertension in patients with viral hepatitis. Medical alphabet. 2021;(20):38-43. (In Russ.) https://doi.org/10.33667/2078-5631-2021-20-38-43

Views: 439


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)