Value of spiral CT in evaluating the dynamic evolution of hypersplenism after partial splenic embolization

ObjectiveTo make a mid-term follow-up for patients with cirrhosis and hypersplenism after partial splenic embolization(PSE), and to compare the changes of CT, peripheral blood cells and complications in embolization area and spleen tissue of patients with different percentage of embolic volume.

MethodsForty-three patients with cirrhosis and hypersplenism treated with PSE were divided into group A(≤ 50%) and group B(>50%) according to the percentage of splenic embolization volume.The CT manifestations of upper abdomen, the changes of peripheral blood cells and the occurrence of complications were compared between the two groups before operation, 1 week, 4 weeks, 10 weeks and 6 months after operation.

ResultsLiquefaction necrosis was found in 1 case in group A at 4 weeks after operation and repaired at 6 months after operation; 5 cases of liquefaction necrosis at 4 weeks after operation, 7 cases at 10 weeks after operation, 5 cases at 6 months after operation in group B were found; and there were significant differences in the repair degree of spleen tissue between the two groups at 4 weeks, 10 weeks and 6 months after operation(P < 0.05).There were no significant differences in white blood cell count, red blood cell count and platelet count between the two groups before and after PSE(P>0.05).The incidence of complications in group A(41.38%) was lower than that in group B(71.42%)(P < 0.05).

ConclusionsSpiral CT can show the changes of splenic embolization area and spleen volume after PSE, and evaluate the risk of postoperative complications.The percentage of embolization volume less than 50% during PSE is more helpful for postoperative recovery.