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Deportalization, Venous Congestion, Venous Deprivation: Serial Measurements of Volumes and Functions on Morphofunctional 99mTc-Mebrofenin SPECT-CT

Abstract : The objective was to assess the changes in regional volumes and functions under venous-impaired vascular conditions following liver preparation. Twelve patients underwent right portal vein embolization (PVE) (n = 5) or extended liver venous deprivation (eLVD, i.e., portal and right and middle hepatic veins embolization) (n = 7). Volume and function measurements of deportalized liver, venous-deprived liver and congestive liver were performed before and after PVE/eLVD at days 7, 14 and 21 using 99mTc-mebrofenin hepatobiliary scintigraphy with single-photon emission computed tomography and computed tomography (99mTc-mebrofenin SPECT-CT). Volume and function progressed independently in the deportalized liver (p = 0.47) with an early decrease in function (median -18.2% (IQR, -19.4--14.5) at day 7) followed by a decrease in volume (-19.3% (-22.6--14.4) at day 21). Volume and function progressed independently in the venous deprived liver (p = 0.80) with a marked and early decrease in function (-41.1% (-52.0--12.9) at day 7) but minimal changes in volume (-4.7% (-10.4-+3.9) at day 21). Volume and function progressed independently in the congestive liver (p = 0.21) with a gradual increase in volume (+43.2% (+38.3-+51.2) at day 21) that preceded a late and moderate increase in function at day 21 (+34.8% (-8.3-+46.6)), concomitantly to the disappearance of hypoattenuated congestive areas in segment IV (S4) on CT, initially observed in 6/7 patients after eLVD and represented 35.3% (22.2-46.4) of whole S4 volume. Liver volume and function progress independently whatever the vascular condition. Hepatic congestion from outflow obstruction drives volume increase but results in early impaired function.
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Soumis le : mardi 16 mars 2021 - 14:58:39
Dernière modification le : mardi 24 mai 2022 - 17:42:04
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Lauranne Piron, Emmanuel Deshayes, Christophe Cassinotto, François Quenet, Fabrizio Panaro, et al.. Deportalization, Venous Congestion, Venous Deprivation: Serial Measurements of Volumes and Functions on Morphofunctional 99mTc-Mebrofenin SPECT-CT. Diagnostics, MDPI, 2021, 11 (1), pp.12. ⟨10.3390/diagnostics11010012⟩. ⟨hal-03170866⟩

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