Intrahepatic circulatory time analysis of an ultrasound contrast agent in liver cirrhosis.
OBJECTIVE
To assess the diagnostic accuracy and advantages of intrahepatic circulatory time analysis of an ultrasound contrast agent using pulse-inversion imaging as compared with recently reported noninvasive diagnostic tests for cirrhosis.


METHODS
Forty patients divided into noncirrhotic (nonLC) (n = 20) and compensated cirrhotic (LC) (n = 20) groups were studied prospectively. After intravenous administration of a contrast agent, the arrival times at the hepatic artery (HA), portal vein (PV), and hepatic vein (HV) were measured by pulse-inversion imaging. Intrahepatic circulatory time was calculated as the difference between the HV and HA arrival times (HV-HA interval time) or the HV and PV arrival times (HV-PV interval time).


RESULTS
The HV-HA and HV-PV interval times were significantly shorter in the LC group (7.4 +/- 1.7 and 1.9 +/- 1.5 s, respectively) compared with those in the nonLC group (normal: 15.6 +/- 2.1 and 11.1 +/- 1.7 s, respectively; P < 0.001 and P < 0.001, respectively, and hepatitis: 12.8 +/- 4.1 and 7.8 +/- 4.4 s, respectively; P < 0.001 and P < 0.002, respectively). Each intrahepatic circulatory time showed the highest accuracy rate for cirrhosis in other noninvasive diagnostic tests.


CONCLUSIONS
This analysis, which is considered to reflect intrahepatic hemodynamic changes, is a useful noninvasive diagnostic test for compensated cirrhosis.
Hirota
Masashi
M
Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. hirotam@med.nagoya-u.ac.jp
Kaneko
Tetsuya
T
Sugimoto
Hiroyuki
H
Kure
Shigehiro
S
Inoue
Soichiro
S
Takeda
Shin
S
Nakao
Akimasa
A
D000328:Adult; D000368:Aged; D001682:Biological Availability; D016022:Case-Control Studies; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008102:Liver Circulation / Q000187:drug effects / Q000502:physiology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000493:pharmacokinetics*; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508