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

Orlacchio, Antonio; Bolacchi, Francesca; Petrella, Maria Chiara; Pastorelli, Daniela; Bazzocchi, Gabriele; Angélico, M.; Simonetti, Giovanni

doi:10.1016/j.ultrasmedbio.2010.10.012

Cited by 32 publications

(24 citation statements)

References 25 publications

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“…Compared with contrast-enhanced CT and contrast-enhanced MRI, CEUS is low cost [15,16], repeatable, safer, and can be controlled by operators in real-time during the measurements. Moreover, previous studies have demonstrated that hepatic dynamic CEUS features are correlated with severity of chronic liver diseases (CLD) [17], degree of liver fibrosis [18], and portal pressure [19,20]. In patients with cirrhosis, the occurrence of EV is a consequence of portal hypertension (PH).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Contrast-Enhanced Ultrasonography for Predicting Esophageal Varices in Patients with Hepatitis B Virus (HBV)-Related Cirrhosis

Feng

Peng

et al. 2017

Med Sci Monit

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BackgroundThe aim of this study was to investigate the usefulness of contrast-enhanced ultrasonography (CEUS) in predicting of esophageal varices (EV) and assessing high-risk EV in patients with hepatitis B virus (HBV)-related cirrhosis.Material/MethodsPatients with HBV-related cirrhosis who had undergone endoscopy were prospectively recruited. Hepatic dynamic CEUS was performed. Regions of interest (ROI) were drawn on the hepatic artery, hepatic vein, portal vein, and liver parenchyma to measure the corresponding features, such as arrival times. Spearman’s correlation analysis was used to determine the relations between several dynamic CEUS features and the degree of EV. Receiver operating characteristics (ROC) curves were constructed to investigate the diagnostic performance of CEUS in assessing the presence of EV and high-risk EV.ResultsFifty-eight patients (44 men; mean age 51.3 years) were included in this study. Of these, 18 (31.0%), 12 (20.7%), 11 (19.0%), and 17 (29.3%) of patients had grade 0, 1, 2, and 3 EV, respectively. Grade 2 and grade 3 EV were considered high-risk EV. Among the CEUS features, the area under the ROC curves of intrahepatic transit time (HV–HA, i.e., the difference between hepatic vein arrival time and hepatic artery arrival time) both for assessment of the presence of EV and high-risk EV (0.883 and 0.915, respectively) were larger than the other indices. HV–HA was negatively correlated with the grade of EV. An HV–HA of under 8.2 s indicated the presence of EV and under 7 s indicated high-risk EV.ConclusionsDynamic CEUS imaging is useful in assessing the presence of EV and high-risk EV in patients with HBV-related cirrhosis.

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Section: Introductionmentioning

confidence: 99%

Usefulness of Contrast-Enhanced Ultrasonography for Predicting Esophageal Varices in Patients with Hepatitis B Virus (HBV)-Related Cirrhosis

Feng

Peng

et al. 2017

Med Sci Monit

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“…Nevertheless, as Sonovue does not have an accumulation property in the liver, previous studies with this agent focused on the haemodynamic evaluation; movement of microbubble in the liver, such as transit time between portal vein and hepatic vein or hepatic vein arrival time [3–5]. However, their results do not seem to separate different fibrosis stages; only discriminate advanced fibrosis (F3–F4) from mild fibrosis (F0–F2), probably because of the variability of the haemodynamic-based study, difficulty of the observation of dynamic microbubble or different property of microbubble.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies with sulfur hexafluoride (Sonovue; Bracco, Milan, Italy) have shown the effectiveness of haemodynamic assessment of microbubbles based on time-intensity analysis to diagnose advanced stages of fibrosis, but failed to find a significant difference in the parameters between the different fibrosis grades [3–5]. …”

Section: Introductionmentioning

confidence: 99%

Demonstration of intrahepatic accumulated microbubble on ultrasound represents the grade of hepatic fibrosis

et al. 2011

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ObjectivesTo examine the feasibility of perflubutane-based ultrasound for grading hepatic fibrosis.MethodsThis prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT0.5]).ResultsHigh-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis (P < 0.0001). Intensity difference at 15-min phase showed most significant correlation with fibrosis grade (ρ = 0.79, P < 0.0001), and the best areas under the receiver operating characteristic curves are 0.88 for marked fibrosis, 0.95 for advanced fibrosis and 0.97 for cirrhosis, which were significantly higher than those of FIB4, 0.85 for marked fibrosis, 0.89 for advanced fibrosis and 0.90 for cirrhosis. Sensitivity, specificity and efficiency of the intensity difference were 88%, 72% and 81% for marked fibrosis, 85%, 91% and 89% for advanced fibrosis and 97%, 90% and 91% for cirrhosis, respectively. The subsequent study validated the main study results; significant correlation between the intensity difference and the fibrosis grade (ρ = 0.73–0.77, P < 0.0001).ConclusionsPerflubutane-based ultrasound accurately predicts the grade of hepatic fibrosis.Key Points• The behaviour of intrahepatic microbubbles depends on the severity of hepatic fibrosis.• Layer enhancement pattern simply represents the degree of chronic liver disease.• Parenchymal intensity change due to high-power emission predicts the hepatic fibrosis grade.

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“…Orlacchio et al [73] used time intensity curve analysis and found an AUROC of 0.88 for the distinction between F0-2 vs F3-4. Sugimoto et al [74] proposed a subjective assessment of CEUS images to identify morphologic changes of portal vein branches, reporting AUROCs of 0.96 for F1 vs F2-4 distinction, 0.97 for F1-2 vs F3-4, and 0.91 for F1-3 vs F4.…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Noninvasive diagnosis of cirrhosis: A review of different imaging modalities

Robertis

D’Onofrio

Demozzi

et al. 2014

WJG

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Progressive hepatic fibrosis can lead to cirrhosis, so its early detection is fundamental. Staging fibrosis is also critical for prognosis and management. The gold standard for these aims is liver biopsy, but it has several drawbacks, as it is invasive, expensive, has poor acceptance, is prone to inter observer variability and sampling errors, has poor repeatability, and has a risk of complications and mortality. Therefore, non-invasive imaging tests have been developed. This review mainly focuses on the role of transient elastography, acoustic radiation force impulse imaging, and magnetic resonance-based methods for the noninvasive diagnosis of cirrhosis.

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

Cited by 32 publications

References 25 publications

Usefulness of Contrast-Enhanced Ultrasonography for Predicting Esophageal Varices in Patients with Hepatitis B Virus (HBV)-Related Cirrhosis

Usefulness of Contrast-Enhanced Ultrasonography for Predicting Esophageal Varices in Patients with Hepatitis B Virus (HBV)-Related Cirrhosis

Demonstration of intrahepatic accumulated microbubble on ultrasound represents the grade of hepatic fibrosis

Noninvasive diagnosis of cirrhosis: A review of different imaging modalities

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