Hemodynamic and morphologic changes of peripheral hepatic vasculature in cirrhotic liver disease: a preliminary study using contrast-enhanced coded phase inversion harmonic ultrasonography.
OBJECTIVE
To provide the useful information for the diagnosis of liver cirrhosis by observing the morphology of peripheral hepatic vessels and the hemodynamics of microbubble arrival time in these vessels.


METHODS
Twenty-one subjects including 5 normal volunteers and 16 patients (liver cirrhosis, n=10; chronic hepatitis, n=6) were studied by contrast-enhanced coded phase inversion harmonic sonography (GE LOGIQ 9 series) using a 6-8 MHz convex-arrayed wide-band transducer. The images of peripheral hepatic artery, portal and hepatic vein were observed in real-time for about 2 min after intravenous injection of Levovist. The time when microbubbles appeared in the peripheral vessels (microbubble arrival time) was also recorded. The morphologic changes of peripheral hepatic vasculature were classified as marked, slight, and no changes based on the regularity in caliber, course, ramification, and the delineation of vessels compared to normal subjects.


RESULTS
The microbubble arrival time at peripheral artery, portal, and hepatic vein was shorter in cirrhotic patients than in chronic hepatitis patients and normal subjects. The marked, slight and no morphologic changes of peripheral hepatic vasculature found in 5 (5/6, 83.3%), 1 (1/6, 16.7%), and 0 (0/6, 0%) liver cirrhosis patients, respectively, and in 1 (1/10, 10%), 6 (6/10, 60%), and 3 (3/10, 30%) chronic hepatitis patients, respectively. There was a significant difference between the two groups (P< 0.001).


CONCLUSIONS
Evaluation of the hemodynamics and morphology of peripheral hepatic vasculature by contrast-enhanced coded pulse inversion harmonic sonography can provide useful information for the diagnosis of liver cirrhosis.
Zheng
Rong-Qin
RQ
Department of Ultrasound, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China. ultrasoundzh@sohu.com
Zhang
Bo
B
Kudo
Masatoshi
M
Sakaguchi
Yasuhiro
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000378:metabolism; D005260:Female; D006439:Hemodynamics; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000378:metabolism*; D006503:Hepatic Veins / Q000033:anatomy & histology / Q000378:metabolism*; D006801:Humans; D007275:Injections, Intravenous; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D011134:Polysaccharides / Q000378:metabolism; D011169:Portal Vein / Q000033:anatomy & histology / Q000378:metabolism*; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508