Contrast-enhanced ultrasound evaluation of hepatic microvascular changes in liver diseases.
OBJECTIVE
To assess if software assisted-contrast-enhanced ultrasonography (CEUS) provides reproducible perfusion parameters of hepatic parenchyma in patients affected by chronic liver disease.


METHODS
Forty patients with chronic viral liver disease, with (n = 20) or without (n = 20) cirrhosis, and 10 healthy subjects underwent CEUS and video recordings of each examination were then analysed with Esaote's Qontrast software. CEUS dedicated software Qontrast was used to determine peak (the maximum signal intensity), time to peak (TTP), region of blood value (RBV) proportional to the area under the time-intensity curve, mean transit time (MTT) measured in seconds and region of blood flow (RBF).


RESULTS
Qontrast-assisted CEUS parameters displayed high inter-observer reproducibility (κ coefficients of 0.87 for MTT and 0.90 TTP). When the region of interest included a main hepatic vein, Qontrast-calculated TTP was significantly shorter in cirrhotic patients (vs non-cirrhotics and healthy subjects) (71.0 ± 11.3 s vs. 82.4 ± 15.6 s, 86.3 ± 20.3 s, P < 0.05). MTTs in the patients with liver cirrhosis were significantly shorter than those of controls (111.9 ± 22.0 s vs. 139.4 ± 39.8 s, P < 0.05), but there was no significant difference between the cirrhotic and non-cirrhotic groups (111.9 ± 22.0 s vs. 110.3 ± 14.6 s). Peak enhancement in the patients with liver cirrhosis was also higher than that observed in controls (23.9 ± 5.9 vs. 18.9 ± 7.1, P = 0.05). There were no significant intergroup differences in the RBVs and RBFs.


CONCLUSIONS
Qontrast-assisted CEUS revealed reproducible differences in liver perfusion parameters during the development of hepatic fibrogenesis.
Francesco Ridolfi, Eugenio Brunelli, Division of Gastroenterology, Principe di Piemonte Hospital, 60019 Senigallia, AN, Italy. francescoridolfi71@gmail.com
Francesco
F
Ridolfi
Teresa
T
Abbattista
Paolo
P
Busilacchi
Eugenio
E
Brunelli
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D005355:Fibrosis / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D015588:Observer Variation; D010477:Perfusion; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012984:Software; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media