Lobar hepatic steatosis: Association with portal flow hemodynamics evaluated by multiphasic dynamic contrast-enhanced CT. Issue 160 (March 2023)

• Record Type: Journal Article
• Authors: Kawano, Yosuke; Tanabe, Masahiro; Kameda, Fumi; Higashi, Mayumi; Ihara, Kenichiro; Tanabe, Masaya; Inoue, Atsuo; Kobayashi, Taiga; Ueda, Takaaki; Ito, Katsuyoshi
• Is Part Of: European journal of radiology. Issue 160(2023)
• Publication Date: 2023-03
• Subjects: Lobar hepatic steatosis -- Dynamic contrast-enhanced CT -- Splenic vein -- Superior mesenteric vein -- Portal flow hemodynamics; DCE dynamic contrast-enhanced -- HU Hounsfield unit -- NAFLD non-alcoholic fatty liver disease -- ROI region of interest -- SV splenic vein -- SMC spleno-mesenteric confluence -- SMV superior mesenteric vein; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2023.110688
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: CE values of right lobar steatosis were lower than those of the non-fatty left lobe. CE values of hepatic steatosis areas were different from focal fatty spared areas. Lobar hepatic steatosis may be associated with the portal flow hemodynamics. Abstract: Purpose: This study aimed to evaluate the association of portal flow hemodynamics with lobar hepatic steatosis by means of dynamic contrast-enhanced (DCE) CT. Methods: The study population consisted of 235 patients, 77 with lobar hepatic steatosis (right, n = 67; left, n = 10), 158 with diffuse hepatic steatosis with (n = 76) and without (n = 82) a focal fatty spared area. CT attenuation values (Hounsfield units: HU) of the liver with and without hepatic steatosis were measured in unenhanced and arterial-phase CT. The contrast enhancement (CE) values were calculated as the difference in HU values between unenhanced and arterial-phase CT. Results: In 67 patients with lobar steatosis of the right lobe, the median CE values of the areas of right lobar steatosis were significantly lower than those of the non-fatty left lobe (13 [IQR 7–19] vs 23 [13–33] HU, P < 0.01), suggesting dominant SMV flow to the right lobe with lobar hepatic steatosis. Conversely, in 10 patients with lobar steatosis of the left lobe, the median CE values of the areas of left lobar steatosis were lower than those of the non-fatty right lobe (15.5 [11.75–21.5] vs 16 [14.5–22] HU); however, this difference was not statistically significant ( P = 0.20). In 76 patients with a focal fatty spared area, there were significant differences in the median CE values between hepatic steatosis areas and focal fatty spared areas in the gallbladder fossa group ( P = 0.01) and in the segment IV group ( P < 0.01). Conclusion: Lobar hepatic steatosis may be associated with regional changes of the portal flow hemodynamics (i.e., predominant perfusion from the SMV flow to the lobes with steatosis).