Pathophysiological analysis of nonalcoholic fatty liver disease by evaluation of fatty liver changes and blood flow using xenon computed tomography: can early-stage nonalcoholic steatohepatitis be distinguished from simple steatosis
Journal of Gastroenterology, 05/16/2012
Shigefuku R et al. – Measurements of tissue blood flow (TBF) and lambda value (LV) are useful for evaluating the pathophysiological progression of nonalcoholic steatohepatitis (NASH). In addition, these measurements can facilitate the differential diagnosis of SS and Ea–NASH, which may not be distinguishable by other means.Methods
- The authors used Fick’s principle and the Kety–Schmidt equation to determine the hepatic tissue blood flow (TBF) in 65 NASH patients who underwent xenon computed tomography (Xe-CT).
- They calculated the lambda value (LV), i.e., Xe gas solubility coefficient, in liver and blood.
- They assessed the histological severity of fatty changes and fibrosis on the basis of Brunt’s classification.
- Liver biopsy revealed SS in 9 patients and NASH in 56 patients.
- NASH stages 1 and 2 were classified as early-stage NASH (Ea-NASH; 38 patients) and stages 3 and 4 as advanced-stage NASH (Ad-NASH; 18 patients).
- They evaluated the differences in LV and TBF among the 3 groups.
- LV was significantly lower in the Ad-NASH group than in the SS and Ea-NASH groups.
- Portal venous TBF (PVTBF) was significantly lower in the Ea-NASH group than in the SS group, and PVTBF was lower in the Ad-NASH group than in the Ea-NASH group.
- Total hepatic TBF (THTBF) was significantly different between the SS and Ea-NASH groups and between the SS and Ad-NASH groups.