title: Signal intensity of the liver parenchyma in microbubble contrast agent in the late liver phase reflects advanced fibrosis of the liver.
abstract: BACKGROUND
  Microbubble of Levovist accumulates in liver parenchyma, and the phenomenon has been reported as late liver-specific parenchymal. The aim of the present study was to compare the parenchymal enhancement effect of Levovist with the degree of liver dysfunction.
  
  
  METHODS
  Sixty consecutive patients who consented to be treated were enrolled in this study. Pulse-inversion ultrasonography (US) in the liver parenchymal phase of enhancement with Levovist was performed in a preoperative examination. The mechanical index of pulse-inversion US was set at 1.3. The gray-scale intensity of the non-tumor area of the liver parenchyma at the level of the focal zone was measured. The hepatic fibrosis index was measured in each liver by morphometric analysis. The correlation between the gray-scale intensity of the non-tumor area of the liver parenchyma and the hepatic fibrosis index was assessed.
  
  
  RESULTS
  There was a significant inverse correlation between the gray scale of the liver parenchyma and the hepatic fibrosis index (r = -0.809, P < 0.01). The average signal intensity of the liver parenchyma was 144.5 in a normal liver, 133.6 in chronic hepatitis, and 102.6 in liver cirrhosis, demonstrating a significant difference between a normal and cirrhotic liver (P < 0.01).
  
  
  CONCLUSIONS
  The signal intensity of a microbubble disruption of the liver parenchyma in the late phase of enhancement with Levovist was considered to reflect the degree of hepatic fibrosis.
authors.affiliation: Department of Surgery II, Graduate School & Faculty of Medicine, University of Nagoya, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. kanekot@med.nagoya-u.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kaneko
authors.forename: Osamu
authors.initials: O
authors.lastname: Teshigawara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirota
authors.forename: Soichiro
authors.initials: S
authors.lastname: Inoue
authors.forename: Shin
authors.initials: S
authors.lastname: Takeda
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001682:Biological Availability; D015331:Cohort Studies; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D011134:Polysaccharides / Q000493:pharmacokinetics; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508