Evaluation of Quantitative Portal Venous, Hepatic Arterial, and Total Hepatic Tissue Blood Flow Using Xenon CT in Alcoholic Liver Cirrhosis: Comparison With Liver Cirrhosis C Hideaki Takahashi, Michihiro Suzuki, Hiroki Ikeda, Minoru Kobayashi, Shigeru Sase, Hiroshi Yotsuyanagi, Shiro Maeyama, Shiro Iino, and Fumio Itoh Background/Aims: Xenon computed tomography (Xe-CT) is a noninvasive method of quantify- ing and visualizing tissue blood flow (TBF). For the liver, Xe-CT allows separate measurement of hepatic arterial and portal venous TBF. The present study evaluated the usefulness of Xe-CT as a noninvasive diagnostic procedure for measuring hepatic TBF in alcoholic liver cirrhosis (AL-LC), compared with liver cirrhosis C (C-LC). Methods: Xenon computed tomography was performed on 12 patients with AL-LC and 17 patients with C-LC. The severity of LC was classified according to Child–Pugh classification. Correlations between hepatic TBF and Child–Pugh classification were examined. Correlations of hepatic TBF in Child–Pugh class A to C-LC and AL-LC were also examined. Results: The mean portal venous TBF (PVTBF) was significantly lower in AL-LC than in C-LC (p 5 0.0316). Similarly, the mean total hepatic TBF (THTBF) was significantly lower in AL-LC than in C-LC (p 5 0.0390). PVTBF displayed a significant negative correlation with Child–Pugh score (r 5À 0.396, p 5 0.0368). Conclusions: Measurement of hepatic TBF using Xe-CT is useful as a noninvasive, objective method of assessing the state of the liver in chronic liver disease. Key Words: Xenon, Computed Tomography, Hepatic Tissue Blood Flow, Alcoholic Liver Cirrhosis, Child–Pugh Classification. T HE LIVER RECEIVES a dual blood supply from the portal vein and hepatic artery. These systems are known to use independent mechanisms for adjustment of blood flow. Evaluating hepatic blood flow (HBF) is thus difficult. Recently, HBF has been evaluated using various nonin- vasive methods based on advances in imaging modalities such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). In meth- ods such as color Doppler US (Annet et al., 2003; Bernatik et al., 2002; Fujita et al., 2004; Hirata et al., 2004) and angiography (Chiandussi et al., 1968), intravascular HBF is calculated by measuring flow velocities and vessel diam- eters of the portal vein and hepatic artery. Furthermore, measurement of hepatic tissue blood flow (TBF) has been attempted using enhanced CT and MRI (Annet et al., 2003; Materne et al., 2002; Van Beers et al., 2001). We pre- viously evaluated hepatic TBF in patients with chronic liver disease using xenon CT (Xe-CT), and obtained useful results (Sase et al., 2003; Suzuki et al., 2003). The present study used Xe-CT to separately, quantita- tively, and objectively measure hepatic arterial TBF (HATBF) and portal venous TBF (PVTBF) in patients with alcoholic liver cirrhosis (AL-LC) and liver cirrhosis C (C-LC), and compared AL-LC with C-LC. Correlations between hepatic TBF and Child–Pugh classification were examined. Correlations of hepatic TBF in Child–Pugh class A to AL-LC and C-LC were also examined. PATIENTS AND METHODS Patients Between October 2001 and January 2005, Xe-CT was performed in 12 patients (11 men, 1 woman; age range, 30–69 years; mean age, 55 Æ 12 years) with AL-LC and 17 patients (7 men, 10 women; age range, 57–75 years; mean age, 66 Æ 6 years) with C-LC who were admitted to our hospital. In both groups, the absence of hepatocel- lular carcinoma and etiologies other than alcohol or HCV had been From the Department of Internal Medicine, Division of Gastroenter- ology and Hepatology, St. Marianna University, School of Medicine, Kawasaki, Japan (HT, MS, HI, MK, FI); the Kitakashiwa Rehabilita- tion General Hospital, Kashiwa, Japan (SM); the Anzai Medical Company Ltd.; Tokyo, Japan (SS); the Department of internal Medicine, Division of Infectious Diseases, the University of Tokyo, Tokyo, Japan (HY); and the Kiyokawa Hospital, Tokyo, Japan (SI). Received for publication July 30, 2005; accepted February 17, 2006. Reprint requests: Hideaki Takahashi, MD, Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, 2-16-1 Miyamae-ku, Sugao, Kawasaki 216-5811, Japan; Fax: 81-44-976-5805; E-mail: hide-bo@marianna-u. ac.jp Copyright r 2007 by the Research Society on Alcoholism. DOI: 10.1111/j.1530-0277.2006.00285.x Alcohol Clin Exp Res, Vol 31, No S1, 2007: pp 43S–48S 43S ALCOHOLISM:CLINICAL AND EXPERIMENTAL RESEARCH Vol. 31, No. S1 January 2007