Hepatic haemodynamics: interrelationships between contrast enhancement and perfusion on CT and Doppler perfusion indices

Abstract
This study compares three techniques that evaluate hepatic haemodynamics for the detection of metastatic liver disease to determine the interrelationships between the techniques and to assess their equivalence. The three techniques studied were dedicated CT measurements of hepatic enhancement, CT measurements of perfusion and Doppler perfusion indices. 53 patients with proven malignancies of either breast or colon underwent a single location dynamic CT for measurement of hepatic perfusion and enhancement, whilst a subset of 12 patients underwent both CT perfusion and Doppler perfusion studies. Statistically significant correlations were found between CT arterial phase enhancement and CT arterial perfusion (r=0.612, pr=0.867, pr=0.842, pr=0.797, p=0.002 and r=0.725, p=0.008, respectively). Combined CT arterial and portal perfusion correlated with peak liver enhancement (r=0.614, p< 0.001), but Doppler measurements of portal flow did not correlate with any CT parameter. Increased arterial enhancement, perfusion or flow are valuable additional radiological signs for the presence of hepatic metastases that can be elicited by incorporating any one of these methods into existing imaging protocols.