Evaluation of hepatic tissue blood flow using xenon computed tomography before and after screlotherapy for esophagogastric varices: Comparison between endoscopic injection sclerotherapy and balloon-occluded retrograde transvenous obliteration

Abstract

Background
Xenon computed tomography (Xe-CT) provides a quantitative information on tissue blood flow (TBF). In order to determine change in hepatic arterial TBF (HATBF) and portal venous TBF (PVTBF), Xe-CT was applied to the patients with esophagogastric varices (EGV) before and after endoscopic injection sclerotherapy (EIS) or balloon-occluded retrograde transvenous obliteration (B-RTO).
Methods
Subjects consisted of 45 patients who received EIS (27 men, average age 64.3 ± 11.3 years) and 13 patients who received B-RTO (8 men, average age 67.5 ± 10.3 years). Xe-CT was performed before and after the above vascular occlusive treatments. Change in total hepatic TBF (THTBF) and PVTBF/HATBF (P/A) ratio were determined.
Results
PVTBF and P/A before and after EIS were 28.2 ± 9.0; 32.3 ± 9.2 ml/100 ml/min and 1.6 ± 0.7; 1.9 ± 0.9, respectively. Those before and after B-RTO were 28.5 ± 6.0; 39.0 ± 16.7 ml/100 ml/min and 1.3 ± 0.9; 1.6 ± 0.4, respectively. PVTBF and P/A after EIS were significantly higher than those before EIS (P = 0.002, P = 0.039, respectively). P/A was higher after B-RTO than that before B-RTO (P = 0.029). THTBF and HATBF did not differ significantly before and after EIS or B-RTO.
Conclusions
EIS and B-RTO for EGV could increase PVTBF and P/A ratio and improve arterial flow-dominant liver hemodynamics.