title: Contrast-enhanced ultrasonography using Sonazoid to evaluate changes in hepatic hemodynamics in acute liver injury.
abstract: OBJECTIVE
  Disturbances in hepatic microcirculation are believed to be involved in the mechanisms regulating the progression of acute liver injury (ALI). Evaluation of hepatic hemodynamics in patients with acute liver injury might be helpful in understanding the extent of the intrahepatic microcirculatory disturbances. Therefore, we investigated whether contrast-enhanced ultrasonography (CEUS) is useful to evaluate the changes in hepatic hemodynamics in patients with ALI.
  
  
  METHODS
  CEUS was performed in 21 patients with ALI and coagulopathy. Participants were injected with 0.0075 mL Sonazoid/kg body weight, and time-intensity curves were simultaneously recorded for the hepatic and portal veins. The data were compared with those of 10 healthy volunteers.
  
  
  RESULTS
  The arrival time of Sonazoid in the hepatic vein was similar to that in the portal vein in the patients, whereas the arrival time in the hepatic vein was delayed relative to that in the portal vain in the controls (interval between the hepatic and portal vein arrival times, control vs patients 6.74 ± 3.07 s vs 1.13 ± 1.07 s, P < 0.001). Repeated examination revealed that the interval between the hepatic and portal vein arrival times was extended by improvements in hepatic function. The early arrival of Sonazoid in the hepatic vein in the patients is likely to reflect the formation of intrahepatic shunts as a result of hepatic microcirculatory disturbances.
  
  
  CONCLUSIONS
  CEUS using Sonazoid is a useful method to estimate the changes in hepatic hemodynamics in patients with ALI.
authors: Department of Medicine and Bioregulatory Science, Kyushu University, Japan.
authors: Masayuki
authors: M
authors: Miyazaki
authors: Masaki
authors: M
authors: Kato
authors: Masatake
authors: M
authors: Tanaka
authors: Kosuke
authors: K
authors: Tanaka
authors: Shinichiro
authors: S
authors: Takao
authors: Motoyuki
authors: M
authors: Kohjima
authors: Tetsuhide
authors: T
authors: Ito
authors: Munechika
authors: M
authors: Enjoji
authors: Makoto
authors: M
authors: Nakamuta
authors: Kazuhiro
authors: K
authors: Kotoh
authors: Ryoichi
authors: R
authors: Takayanagi