Dynamic Indicators of Perfusion Computer Tomography at Cirrhosis of the Liver with Portal Hypertension in the Assessment Efficiency of Portosystem Bypass System

The article presents an analysis of perfusion computed tomography indicators in patients with cirrhosis of the liver, who have performed various options for portosystemic shunting to prevent the development of bleeding from varicose veins of the esophagus and stomach. The main objective of the study was to evaluate the effectiveness of decompression during shunting and its effect on liver perfusion parameters. The analysis included 27 patients with cirrhosis of the liver (LC) who underwent portosystemic shunting. The mean age of the patients was 39.0 ± 2.9 years. All patients had a history of one to three episodes of esophageal-gastric hemorrhage. Studies have proved the high information content of perfusion computed tomography in the verification of two interrelated types of changes characteristic of this type of decompression operations: a decrease in the portal fraction (PF) of liver perfusion from 144.6 ± 2.1 to 128.4 ± 2.2 ml / 100 ml / min (p <0.001) with stimulation of compensatory reserves with an increase in arterial inflow (AF) from 40.2 ± 0.9 to 47.3 ± 0.9 ml / 100ml / min (p <0.001) and, accordingly, a significant increase in the value of the portal index (PI) from 22.2 ± 0.4 to 27.9 ± 0.6% (p <0.001), providing in the immediate postoperative period or improving the functional status of the stable state of hepatocytes by MELD scale.