Objective To summarize the CT manifestations of early hepatic sinusoidal injury(HSI)caused by oxalipla-tin and analyze their diagnostic value.Methods The retrospective study was approved by the institutional review board,and informed consent was waived.The medical records of patients receiving oxaliplatin containing chemotherapy regimens were reviewed,and the imaging and liver function biochemical data of patients with heterogeneous hypoattenuation of liver parenchyma on the portal venous phase of enhanced CT were collected.The range and distribution of hepatic parenchymal hypoattenuation caused by contrast agent perfusion reduced for sinus injury,the enhancement characteristics of the surround-ing relatively normal liver parenchyma,other accompanying imaging signs,and the magnitude of changes in liver function bi-ochemical indexes were analyzed.Results A total of 62 patients who met the requirements were collected.When the he-patic sinus is damaged after chemotherapy,the hypoattenuation areas of the liver caused by the decrease in perfusion of io-dine contrast agent in enhanced scanning varies in size and range at all levels,and can be micronodular,puddle or large-area flaky,and is divided into multifocal 1 case,peripheral 9 cases and diffuse 52 cases according to the distribution of hypoat-tenuation.In all 62 cases,the relatively normal liver parenchymal patch"piebald"enhancement between lesions was visi-ble,and the"clover"like enhancement was seen in the second liver portal area in 17 cases.Other accompanying CT signs included 50 cases of hepatomegaly,15 cases of stenosis of the main hepatic vein,13 cases of flattening of the inferior vena cava,59 cases of splenomegaly,3 cases of ascites,25 cases of periportal edema,16 cases of gallbladder wall thickening,and 4 cases of esophageal varices.When 62 patients had oxaliplatin-related sinusoidal injury imaging findings,most of the bio-chemical indexes of liver function were still within the upper limit of the reference value or slightly increased,and only one case reached the laboratory threshold for drug-induced liver injury(DILI).Conclusion Oxaliplatin-induced HSI is inap-plicably assessed using laboratory threshold criteria for DILI.Heterogeneous hypoattenuation of the liver parenchyma on the portal venous phase of enhanced CT is a direct sign of oxaliplatin induced HSI,while"piebald","clover"like enhancement and other accompanying signs in the liver parenchyma are indirect signs of HSI.
Tomography,X-raycomputed Chemical and drug induced liver injuryOxaliplatin
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