Assessing Liver Hemodynamics in Children With Cholestatic Cirrhosis by Use of Dual-Energy Spectral CT.

OBJECTIVE. The purpose of this study was to evaluate the value of dual-energy CT (DECT) in assessing liver hemodynamics in children with cholestatic cirrhosis. MATERIALS AND METHODS. The cases of 60 children with cholestatic cirrhosis (study group) and 15 children with inherited metabolic diseases but normal liver function (control group) were retrospectively evaluated. Enhanced CT scans were obtained in spectral imaging mode. Iodine concentration (IC) of hepatic parenchyma in the arterial phase (ICA) and portal venous phase (ICP) was measured on iodine-water material decomposition images. The hepatic arterial iodine fraction (AIF) was calculated as: AIF = ICA / ICP. The ICA, ICP, and AIF of children in the control and study groups were analyzed by one-way ANOVA and post hoc test with Bonferroni correction. The radiation dose was recorded. RESULTS. There were differences in ICA and AIF between the control and study groups. The values in patients in the Child-Pugh class C group were the highest and those in the control group the lowest (p < 0.05). Statistically significant differences in ICP were not found (p > 0.05). Specifically, the multiple comparison results indicated that there were differences in both ICA and AIF in most of the groups (p < 0.05). The volume CT dose index value for all patients was the same at 10.14 mGy for each enhanced phase, and the total dose-length product varied between 402.68 and 679.18 mGy-cm. CONCLUSION. ICA and AIF obtained at dual-energy CT can be used as semiquantitative indicators to evaluate the liver hemodynamics of children with cholestatic cirrhosis.