The Value Of CTPI And IVIM-DWI In Diagnosing Hepatic Warm Ischemia Reperfusion Injury

Objective: This study was to determine whether the CTPI and IVIM-DWI could be used to characterize different degrees of hepatic ischemia reperfusion injury in a rabbit model of hepatic warm ischemia reperfusion injury and combined with combine with clinical laboratory examination indexes and pathology examination result.Methods: New Zealand rabbits underwent 40 min and 60 min of right posterior lobe ischemia followed by 6h reperfusion(each n=10),named as W1,W2 respectively.10 rabbits were taken as normal controls(W0).All the rabbits underwent 3.0 T clinical MR scanner for IVIM-DWI,then performed CT perfusion examinations.The IVIM-DWI indices of ADC,D*,D,PF,and the perfusion indices of arterial flow(AF),portal flow(PF),perfusion index(PI)were measured on the workstation.Blood samples were taken from the rabbit ear vein to measure the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and lactate dehydrogenase(LDH).The contents of total superoxide dismutase(SOD),malondialdehyde(MDA)and myeloperoxidase(MPO)in liver tissue were determined,and histopathological changes were examined..Statistical analyses were performed with APSS19.0 software.For all tests,a P value less than 0.05 was considered to indicate a statistically significant difference.One-way analysis of variance(ANOVA)was used to determine differences.All of the CTPI and IVIM-DWI parameters,biochemical and histopathological parameters were analyzed by Pearson and Spearman correlation methods.Receiver operating characteristic(ROC)curves were used to determine diagnostic efficacies.Results:(1)CTPI parameters:There was significant difference among the three groups in infarct area between W0,W1 and W2 group(P<0.05).There was a significant difference among the three groups in the non-infarcted area between W0,W1 and W2group(P<0.05).There as a significant difference in IVIM-DWI parameters between different groups(P < 0 05).(2)W1 and W2 group: PI,infarction area was higher than that in non-infarctionarea(P < 0.05).PF,infarction area was lower than that in non-infarction area(P <0.001).In the AF value of W2 group,infarction area was higher than the non-infarction area,and the difference was statistically significant(P < 0.009).(3)CTPI parameters:in infarction area,there was a positive correlation between PI,PF and ALT,AST,MDA,MPO,and negative correlation with LDH,SOD(P < 0.05).in non-infarction area: There was a positive correlation between PI,AF and ALT,AST,MDA,MPO(P < 0.01),and a negative correlation(P < 0.05)with SOD.All IVIM-DWI parameters were negatively correlated with ALT,AST,and positively correlated with SOD,D and D* were negatively correlated with LDH.(4)PI,PF has a higher diagnostic efficiency when evaluating the infarct area with different time of warm ischemia.PI,AF has a higher diagnostic efficacy when evaluating the non-infarction area at different time of warm ischemia.ADC,D*,D had higher diagnostic efficacy,AUC > 0.900 and PF > 0.800.(5)The IVIM-DWI parameter ADC,D*,f was negatively correlated with PI,AF,but not with PF.Conclusion:1.CT perfusion imaging parameters are highly sensitive to the pathophysiological changes induced by hepatic WIRI.2.IVIM-DWI can quantitatively evaluate the degree of liver injury and microcirculation changes after WIRI in rabbits.