Contrast-enhanced ultrasound to evaluate the severity of chronic hepatitis C

Ridolfi, F.; Abbattista, T.; Marini, Francesco; Vedovelli, A.; Quagliarini, P.; Busilacchi, P; Brunelli, E.

doi:10.1016/j.dld.2007.06.006

Cited by 46 publications

(41 citation statements)

References 27 publications

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“…In addition, intrahepatic shunts may develop between branches of the portal vein, hepatic vein, and hepatic artery. Porto-systemic collateral vessels may increase resistance to portal blood flow, and their formation precedes the clinical manifestations of hypertension per se (20) . At issue is to what extent fibrosis, inflammation, and steatosis may modify the arterial and venous hepatic vascular patterns before cirrhosis is established, and what would be the ideal non-invasive method for diagnosing and grading fibrosis levels.…”

Section: Discussionmentioning

confidence: 99%

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Rocha

Diniz²,

Borges

et al. 2012

Arq. Gastroenterol.

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-Context -Hepatitis C is an important cause of chronic liver disease worldwide. The grading of hepatic fibrosis in chronic hepatitis C is important for better clinical management. However, until now, liver biopsy is the only test accepted for this purpose, despite their contraindications and complications. New methods for non-invasive assessment of hepatic fibrosis are under investigation. One proposal is the Doppler ultrasound, as a non-invasive, widely available and inexpensive. Objective -To compare Doppler parameters of portal vein in patients with chronic hepatitis C with a healthy control group and to correlate these parameters with fibrosis degree obtained by liver biopsy. Methods -Fifty patients with chronic hepatitis C submitted to liver biopsy and 44 healthy controls had Doppler of the portal vein performed, with the calculation of the portal venous index. We conducted a comparison between the averages of the two groups of portal venous index. For the correlation between portal venous index and fibrosis was employed the Spearman test. Results -There was a difference between the average portal venous index between controls (0.33 ± 0.07) and patients (0.23 ± 0.09) with P<0.001. No difference was observed between the portal venous index in patients with chronic hepatitis C who have significant fibrosis or not. The correlation between the portal venous index and fibrosis degree was reverse and moderate (r =-0.448 P<0.001). The area under the ROC curve was 78.4% (95% CI: 68.8% to 88%). The cutoff for the portal venous index was 0.28 with sensitivity of 73.5% and specificity of 71.1%. Conclusion -The portal venous index was useful in distinguishing healthy patients from patients with CHC. However, there was no significant difference in the quantification of degree of fibrosis.

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Section: Discussionmentioning

confidence: 99%

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Rocha

Diniz²,

Borges

et al. 2012

Arq. Gastroenterol.

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“…Indeed, CEUS-derived time-acoustic intensity curves reflects the tissue-of-interest hemodynamics by measuring the changes of intensity of the harmonic frequencies versus time (Krix 2005). The majority of the previously published CEUS studies in patients with chronic diffuse liver disease places great emphasis on the hepatic artery-tovein time-acoustic intensity curves (Staub et al 2009;Searle et al 2008;Ridolfi et al 2007;Lim et al 2005;Blomley et al 2003;Albrecht et al 1999;Pedersen et al 2005). However, there are limited data to date on liver CEUS perfusion imaging in patients with diffuse liver disease (Kaneko et al 2005) CEUS-related perfusion parameters include time to enhancement (ET), time to peak intensity (PIT), peak signal intensity (PSI), enhancement duration (ED) and area under the curve (AUC).…”

Section: Introductionmentioning

confidence: 99%

Liver Contrast Enhanced Ultrasound Perfusion Imaging in the Evaluation of Chronic Hepatitis C Fibrosis: Preliminary Results

Orlacchio

Bolacchi

Petrella

et al. 2011

Ultrasound in Medicine & Biology

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Abstract-We wanted to determine whether liver contrast-enhanced ultrasound (CEUS)-derived peak signal intensity (PSI) and peak signal intensity/time (PIT) predict liver fibrosis in chronic hepatitis C (CHC). Fortynine patients with CHC (METAVIR classification) and 10 control subjects were included in the study. After a bolus of 2.4 mL SonoVue (Bracco Imaging, Milan, Italy) solution was injected into a peripheral vein, the right lobe of the liver containing the right portal vein was scanned in a transverse section. Two-dimensional sonography was performed using the Philips iU22 ultrasound system (Philips Healthcare, Best, the Netherlands). A 1.0-5.0-MHz (C5-1) wideband convex transducer was used, applying the following settings in all cases. Regions of interest were manually drawn over the right liver lobe and over the portal vein (PV). Liver parenchyma PSI (LPpsi) and PIT (LPpit), portal vein PSI (PVpsi) and PIT (PVpit) were automatically calculated. dPSI was defined as the difference between PVpsi and LPpsi. A significant correlation was observed between PA PSI and fibrosis scores. When patients were stratified according to their LPpsi, a significant difference was achieved only between patients with fibrosis score 0-1 vs. 2-3 and 2 vs. 4. Statistically significant differences between all fibrosis scores, except 0 vs. 1 and 3 vs. 4 were observed when dPSI was used to stratify patients. Overall diagnostic accuracy of LPpsi and dPSI measurement for severe fibrosis by area under the receiving operator characteristic curve analysis was, respectively, 0.87 and 0.88. We suggest that liver CEUS perfusion could have the potential to be used as a complementary tool for the evaluation of liver fibrosis. However, further large-scale studies are required to accurately assess its accuracy in the evaluation of liver fibrosis. (E-mail: aorlacchio@uniroma2.it) Ó 2011 World Federation for Ultrasound in Medicine & Biology.

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“…16 Several articles have shown that contrast-enhanced sonographic parameters are useful for making a differential diagnosis and predicting the severity of liver disease as well as liver fibrosis and cirrhosis. [7][8][9][10][11]17 Albrecht et al 7 reported that patients with cirrhosis have an earlier contrast agent arrival time in their hepatic veins than control participants and patients with diffuse noncirrhotic liver disease. This result was also confirmed by Ridolfi et al 9 In their study, the hepatic vein arrival time had a strong correlation with the presence or absence of clinically evident hepatitis C virus-related cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Studies have shown that intrahepatic circulatory time analysis of a sonographic contrast agent is highly sensitive for diagnosing cirrhosis and can be used to assess the severity of liver disease. [7][8][9][10][11] As we know, liver fibrous degeneration is associated with portal hypertension in patients with chronic liver disease. Therefore, we hypothesized that intrahepatic circulatory time analysis of a sonographic contrast agent might predict portal venous pressure changes in patients with chronic liver diseases and cirrhosis.…”

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confidence: 99%

Noninvasive Analysis of Portal Pressure by Contrast-Enhanced Sonography in Patients With Cirrhosis

Zhang

et al. 2011

Journal of Ultrasound in Medicine

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Objectives Free portal pressure measurement is a reliable method for assessment of portal pressure in patients with cirrhosis. Intrahepatic circulatory time analysis of a sonographic contrast agent can assess liver fibrosis and its severity. The purposes of this pilot study were to assess the correlation between the intrahepatic circulatory time and free portal pressure and to assess whether intrahepatic circulatory time analysis can be used to predict portal venous pressure severity. Methods The intrahepatic circulatory time and free portal pressure were measured in 31 patients with hepatitis B virus–related liver disease. Pearson correlation analysis was used to assess the correlation between the intrahepatic circulatory time and free portal pressure. Results The hepatic vein–hepatic artery interval times were significantly shorter in the portal hypertension group than the non–portal hypertension group (mean ± SD, 8.26 ± 1.94 and 13.83 ± 1.17 seconds, respectively; P < .001). The portal vein–hepatic artery interval times were significantly longer in the portal hypertension group than the nonportal hypertension group (13.13 ± 2.25 and 7.25 ± 1.81 seconds; P < .001). Considering the whole patient population, there were statistically significant correlations between free portal pressure and the hepatic vein–hepatic artery interval time (r = −0.900; P < .001) and portal vein–hepatic artery interval time (r = 0.808; P < .001). In patients with portal hypertension, there was a statistically significant correlation between free portal pressure and the hepatic vein–hepatic artery interval time (r = −0.804; P = .009) and a weak correlation between free portal pressure and the portal vein–hepatic artery interval time (r = 0.506; P = .036). Conclusions Intrahepatic circulatory time measurement is correlated with free portal pressure and has the potential capability to evaluate portal pressure noninvasively in patients with hepatitis B virus–related liver disease.

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Contrast-enhanced ultrasound to evaluate the severity of chronic hepatitis C

Cited by 46 publications

References 27 publications

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Liver Contrast Enhanced Ultrasound Perfusion Imaging in the Evaluation of Chronic Hepatitis C Fibrosis: Preliminary Results

Noninvasive Analysis of Portal Pressure by Contrast-Enhanced Sonography in Patients With Cirrhosis

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