Transient splenic inhomogeneity with contrast-enhanced CT: mechanism and effect of liver disease.

Abstract

To use computed tomography (CT) and functional imaging to characterize the physiologic processes that result in transient splenic inhomogeneity during contrast material enhancement and determine their value in detection of diffuse liver disease. CT scan data from nine control patients and 13 patients with diffuse liver disease were used to create functional images that displayed splenic perfusion and time to peak enhancement. A pixel-by-pixel analysis was used to create these images. Areas of early enhancement demonstrated higher perfusion and vice versa. In patients with liver disease, splenic perfusion values fell from 1.44 to 1.22 mL/min/mL in the areas that showed early enhancement and 1.24 to 0.89 mL/min/mL in the areas that showed late enhancement. As splenic perfusion values fell, the size of the regions that showed late enhancement increased. The combination of functional images and CT data has clarified the mechanism by which transient splenic inhomogeneity occurs and is of potential value in the detection of diffuse liver disease.