Abstract
Purpose: To determine the prognostic factors of transcatheter arterial steroid injection therapy (TASIT) in patients with severe acute hepatic failure, with special reference to computed tomography (CT) findings.
Material and Methods: Fifty-one patients (32 men, 19 women; mean age, 48 years) who underwent TASIT for severe acute hepatic failure at the authors' institution were enrolled. Based on patient outcomes, the patients were divided into effective and ineffective treatment groups. Attenuation of the liver parenchyma and liver volume were calculated from CT data acquired before TASIT. Miscellaneous CT findings, such as heterogeneous enhancement of the liver parenchyma, periportal edema, ascites, gall bladder wall thickening, lymphadenopathy and splenomegaly, were also evaluated. The data were compared between the groups.
Results: The effective and ineffective treatment groups included 39 and 12 patients, respectively. All patients in the ineffective group were diagnosed with fulminant liver failure. Mean attenuation of the liver parenchyma in all patients was 44.0 Hounsfield units (HU). Mean CT value in the liver parenchyma was higher in the effective (44.7 HU) than in the ineffective (40.1 HU) treatment groups; however, the difference was not statistically significant. Of the 15 patients in whom liver parenchyma CT values were > 45 HU, all responded to TASIT. Mean liver volume and miscellaneous CT findings were not significantly different between the effective and ineffective treatment groups.
Conclusion: Relatively preserved attenuation of the liver parenchyma may be a good prognostic factor for severe acute hepatic failure after TASIT.
