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Changes in liver perfusion and function before and after percutaneous occlusion of spontaneous portosystemic shunt

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Abstract

Purpose

To evaluate changes in liver perfusion after occlusion of spontaneous portosystemic shunt and to analyze mechanisms of liver profile improvement.

Materials and methods

Liver function changes and portal venous and hepatic arterial blood flow were evaluated using perfusion CT before and after shunt occlusion in 23 patients who underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n = 15) or hepatic encephalopathy (n = 8).

Results

Portal venous blood flow was significantly higher at 1 week (278.7 ml/min, 92.7–636.7, p = 0.012), 1 month (290.0 ml/min, 110.1–560.1, p < 0.001) and 3 months (299.6 ml/min, 156.7–618.5, p = 0.033) after shunt occlusion than the baseline (220.9 ml/min, 49.5–566.7). Hepatic arterial liver blood flow became lower than the baseline (132.3 ml/min, 47.9–622.3) after shunt occlusion, but a significant decrease was observed only at 1 month later (107.9 ml/min, 45.8–263.6 p = 0.027). Serum albumin concentration became significantly higher than the baseline (3.4 mg/dl, 1.9–4.5) at 1 month (3.8 mg/dl, 2.3–4.3, p = 0.018) and 3 months (3.9 mg/dl, 2.6–4.3, p = 0.024) after shunt occlusion.

Conclusion

Shunt occlusion increases portal venous blood flow and decreases hepatic arterial blood flow, thereby improving the liver profile.

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Authors and Affiliations

  1. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yasukazu Kako, Koichiro Yamakado, Koichiro Asada, Haruyuki Takaki, Kaoru Kobayashi & Shozo Hirota

  2. Department of Radiological Technology, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Wataru Jomoto & Toshiya Nasada

  3. Department of Biostatistics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Takashi Daimon

Authors
  1. Yasukazu Kako
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  2. Koichiro Yamakado
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  3. Wataru Jomoto
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  4. Toshiya Nasada
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  6. Haruyuki Takaki
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  7. Kaoru Kobayashi
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  8. Takashi Daimon
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  9. Shozo Hirota
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Correspondence to Yasukazu Kako.

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The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kako, Y., Yamakado, K., Jomoto, W. et al. Changes in liver perfusion and function before and after percutaneous occlusion of spontaneous portosystemic shunt. Jpn J Radiol 35, 366–372 (2017). https://doi.org/10.1007/s11604-017-0647-6

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  • DOI: https://doi.org/10.1007/s11604-017-0647-6

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