J Korean Radiol Soc.  2008 Apr;58(4):409-416. 10.3348/jkrs.2008.58.4.409.

Renal Hypoperfusion Associated with Splenorenal Shunts in Liver Cirrhosis

• Byun JN
• Kim DH
• Kang SG

• KMID: 1479106
• DOI: http://doi.org/10.3348/jkrs.2008.58.4.409

Abstract

PURPOSE
To determine whether spontaneous a splenorenal shunt can be used as an imaging predictor of early renal hemodynamic changes in patients with cirrhosis.
MATERIALS AND METHODS
The study included 82 cirrhotic patients and 41 control subjects. Three-phase CT was performed and CT attenuation values (Hounsfield units) of the renal cortex in three phases were measured to evaluate renal perfusion. Likelihood ratio tests for trend were conducted for age, presence of ascites, and Child's grade.
RESULTS
The mean CT attenuation values of the renal cortex in cirrhotic patients were significantly lower than the values of control subjects in three phases: 153.3 +/- 37.9 versus 173.3 +/-25.2 in the arterial phase, 172.6 +/- 41.0 versus 197.6 +/- 26.5 in the portal phase and 136.9 +/- 26.0 versus 152.7 +/- 20.0 in the delayed phase, respectively. The mean CT attenuation value of cortices in patients with renal hypoperfusion was 119.9 +/- 11.8 in the portal phase. Child's class C (aOR: 58.4, 95% CI: 3.6-956.2; p < 0.01) and the presence of a renal shunt (aOR: 7.5, 95% CI: 1.8-30.5; p < 0.01) were associated with renal hypoperfusion. The incidence of renal hypoperfusion was associated with Child's grade (trend: p < 0.01), and not with the grade of ascites or age.
CONCLUSION
A dilated spontaneous splenorenal shunt may be a risk factor for renal hypoperfusion in cirrhosis.

Keyword

Abdomen, CT; Liver, cirrhosis; Shunts, splenorenal

MeSH Terms

Ascites
Fibrosis
Hemodynamics
Humans
Incidence
Liver
Liver Cirrhosis
Perfusion
Risk Factors
Splenorenal Shunt, Surgical