Spectral CT in the evaluation of hepatic function before and after treatment of Budd-Chiari syndrome

Objective To investigate the use of spectral CT in assessing the treatment effect on hepatic function in patients with Budd-Chiari syndrome (BCS) before and after treatment. Methods From Dec. 2015 to Mar. 2017, 41 patients with BCS underwent Spectral CT before and after treatment (mean time interval from treatment 1~3 months) in the First Affiliated Hospital of Zhengzhou University. The Iodine concentration (IC) measured on the hepatic section Ⅰ-Ⅷ in the portal venous phase were normalized to the aorta (NIC). The clinical indicators of liver function were studied including Prothrombin time (PT), Albumin(Alb), Total bilirubin (TBil), Aspartate transaminase (AST), and Alanine transarminase (ALT). The paired t test was used to compare NIC and the various indices of hepatic function before and after treatment. The correlation before and after treatment between NIC and the different liver functions were analyzed by the Pearson correlation analysis. Results While both PT and TBil were negatively correlated (P<0.05), Alb was positively correlated with hepatic NIC (P<0.05). The correlation of PT, Alb and TBil in patients with Child-Pugh class A liver function were higher than those in classes B and C(r=-0.749, 0.658, -0.511). The NIC in the hepatic section Ⅰ-Ⅷ after treatment were higher than those before treatment, with significant differences in hepatic section Ⅱ-Ⅷ. The differences between after and before treatment in patients with Child-Pugh class C liver function were higher than those in classes A and B. The hepatic section Ⅳ, Ⅴ, Ⅷ of class A, the hepatic section Ⅲ-Ⅷ of class B, hepatic section Ⅱ-Ⅷ of classes C were statistically significant. Compared with patients before treatment, the indices of liver function in patients after treatment showed better results (shorter PT, higher ALB, lower TBil, ALT and AST). Conclusion Normalized iodine concentration from spectral CT was helpful in evaluating liver function in patients with BCS. Key words: Budd-Chiari syndrome; X-ray computed tomography; Spectral imaging; Angiography