Iodine density Changes in Hepatic and Splenic Parenchyma in Liver Cirrhosis with Dual Energy CT (DECT): A Preliminary Study

Abstract

To investigate the hemodynamic changes in liver cirrhosis by comparing iodine density in hepatic and splenic parenchyma with 8 cm detector dual energy CT (DECT). Forty-six consecutive patients with liver cirrhosis and 22 healthy volunteers were recruited in this study, and they were all performed contrast enhanced examination with 8 cm detector DECT. All raw data were reconstructed with 1.25 mm slice thickness, Iodine density (in milligrams per milliliter) were measured on iodine-based material decomposition images. Quantitative indices of iodine density (ID), including normalized ID of liver parenchyma for arterial phase (NIDLAP), ID of liver parenchyma for venous phase (IDLVP), ID of splenic parenchyma for arterial phase (IDSAP), ID of splenic parenchyma for venous phase (IDSVP), ID of portal vein in venous phase (IDPVP) and Liver arterial iodine density fraction (AIF) were measured and compared between two groups. The correlation between Child-Pugh grade and other quantitative indices were calculated, with statistical significance as P<0.05. For all 46 liver cirrhosis patients, 10 were classified in grade A, 24 in Grade B and 12 in Grade C. Compared with control group, patients with liver cirrhosis showed (1) no statistical difference in general data (age, gender, height and weight) (all P>0.05), (2) higher iodine density of NIDLAP, IDSVP, IDPVP and AIF, and lower NIDSAP (all P<0.01), (3) NIDLAP, AIF, IDSVP and IDPVP in grade A were all lower than Grade B and C (all P<0.01). (4) AIF and NIDLAP showed positive correlation with Child-Pugh grade, with coefficient of R = 0.71 and R = 0.46, respectively. Based on iodine density measurement in DECT, it is possible to evaluate the hemodynamic changes in liver and spleen parenchyma in liver cirrhosis. Quantitative indices of AIF and NIDLAP demonstrate positive correlation with Child-Pugh grade, which accommodates potential possibility for DECT as a noninvasive tool in assessing the severity of liver cirrhosis.