Does hepatic vein transit time performed with contrast-enhanced ultrasound predict the severity of hepatic fibrosis?
Previously published data suggest a hepatic vein transit time (HVTT) threshold of more than 24 s can distinguish mild to moderate from advanced fibrosis. In this study, we attempted to validate HVTT as a noninvasive index of hepatic fibrosis. Patients were scanned using real-time, pulse-inversion mode following bolus injections of the contrast agent Definity. HVTT was correlated with the degree of fibrosis obtained from contemporaneous liver biopsy. The study population included 40 patients with chronic liver disease and five healthy volunteers. Mean HVTT correlated with histologic grade as follows: absence/minimal fibrosis (n = 18), 25.6 ± 11.8 s; moderate fibrosis (n = 17), 21.5 ± 5.9 s; and severe fibrosis (n = 8), 20.9 ± 5.5 s, (p = .615). Poor sensitivity (57%) and specificity (43%) prevent validation of the previously published HVTT threshold as a surrogate marker of hepatic fibrosis. Further work investigating the different interaction of Definity, SonoVue and Levovist with the reticulo-endothelial system may help explain the discrepant results reported here.
Department of Medical Imaging, University of Toronto, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
An
A
Tang
Tae Kyoung
TK
Kim
Jenny
J
Heathcote
Maha
M
Guindi
Hyun-Jung
HJ
Jang
Raffi
R
Karshafian
Peter N
PN
Burns
Stephanie R
SR
Wilson
D000328:Adult; D000368:Aged; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D005466:Fluorocarbons / Q000493:pharmacokinetics*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren