Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 7, 2012; 18(37): 5225-5230
Published online Oct 7, 2012. doi: 10.3748/wjg.v18.i37.5225
Contrast-enhanced ultrasound evaluation of hepatic microvascular changes in liver diseases
Francesco Ridolfi, Teresa Abbattista, Paolo Busilacchi, Eugenio Brunelli
Francesco Ridolfi, Eugenio Brunelli, Division of Gastroenterology, Principe di Piemonte Hospital, 60019 Senigallia, AN, Italy
Teresa Abbattista, Division of Radiology, Principe di Piemonte Hospital, 60019 Senigallia, AN, Italy
Paolo Busilacchi, SIUMB School of Ultrasound of Ancona, Principe di Piemonte Hospital, 60019 Senigallia, AN, Italy
Author contributions: Ridolfi F and Abbattista T designed the study, performed the examinations and wrote the manuscript; and Busilacchi P and Brunelli E provided the analytical tools and edited the manuscript.
Supported by Associazione per la Prevenzione e Cure delle Patologie dell’Apparato Digerente-Associazione di Volontariato-grant
Correspondence to: Francesco Ridolfi, MD, PhD, Division of Gastroenterology, Principe di Piemonte Hospital, Via Cellini 1, 60019 Senigallia, AN, Italy. francescoridolfi71@gmail.com
Telephone: +39-71-79092606 Fax: +39-71-79092604
Received: April 1, 2012
Revised: May 31, 2012
Accepted: August 4, 2012
Published online: October 7, 2012
Abstract

AIM: To assess if software assisted-contrast-enhanced ultrasonography (CEUS) provides reproducible perfusion parameters of hepatic parenchyma in patients affected by chronic liver disease.

METHODS: Forty patients with chronic viral liver disease, with (n = 20) or without (n = 20) cirrhosis, and 10 healthy subjects underwent CEUS and video recordings of each examination were then analysed with Esaote’s Qontrast software. CEUS dedicated software Qontrast was used to determine peak (the maximum signal intensity), time to peak (TTP), region of blood value (RBV) proportional to the area under the time-intensity curve, mean transit time (MTT) measured in seconds and region of blood flow (RBF).

RESULTS: Qontrast-assisted CEUS parameters displayed high inter-observer reproducibility (κ coefficients of 0.87 for MTT and 0.90 TTP). When the region of interest included a main hepatic vein, Qontrast-calculated TTP was significantly shorter in cirrhotic patients (vs non-cirrhotics and healthy subjects) (71.0 ± 11.3 s vs 82.4 ± 15.6 s, 86.3 ± 20.3 s, P < 0.05). MTTs in the patients with liver cirrhosis were significantly shorter than those of controls (111.9 ± 22.0 s vs 139.4 ± 39.8 s, P < 0.05), but there was no significant difference between the cirrhotic and non-cirrhotic groups (111.9 ± 22.0 s vs 110.3 ± 14.6 s). Peak enhancement in the patients with liver cirrhosis was also higher than that observed in controls (23.9 ± 5.9 vs 18.9 ± 7.1, P = 0.05). There were no significant intergroup differences in the RBVs and RBFs.

CONCLUSION: Qontrast-assisted CEUS revealed reproducible differences in liver perfusion parameters during the development of hepatic fibrogenesis.

Keywords: Contrast enhanced ultrasound, Cirrhosis, Hepatitis, Liver perfusion, Hepatic microcirculation