title: Noninvasive diagnosis of compensated cirrhosis using an analysis of the time-intensity curve portal vein slope gradient on contrast-enhanced ultrasonography.
abstract: OBJECTIVE
  We measured the slope gradients (SGs) of the vascular time-intensity curves (TICs) of the intrahepatic vessels on contrast-enhanced ultrasonography (CEUS). The aim of this study was to assess the diagnostic accuracy of the SG of each hepatic vessel, particularly the portal vein (PV), for detecting cirrhosis and to compare this method with conventional modalities.
  
  
  METHODS
  Fifty-one preoperative patients underwent CEUS, and the TICs were plotted. The SGs of the hepatic artery, PV and hepatic vein were obtained from the linear functions between the slope of the arrival time of the contrast agent and the peak enhancement time of each vessel. The transit times and levels of biochemical markers were also measured. The patients were divided into three groups according to the Metavir score: F0/1 group (n = 14), F2/3 group (n = 21) and F4 group (n = 16).
  
  
  RESULTS
  The PVSG significantly decreased in the F4 group (F0/1: 29.1 ± 2.27, F2/3: 23.1 ± 1.86, F4: 14.7 ± 2.13). The PVSG demonstrated high accuracy for diagnosing cirrhosis and was correlated with the levels of ICG-R15 and hyaluronic acid (Spearman rank correlation; ρ = -0.5691, p < 0.001 and ρ = -0.4652, p = 0.0006).
  
  
  CONCLUSIONS
  The PVSG has the potential to be a diagnostic marker for identifying patients with well-compensated cirrhosis.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 8300011, Japan, gotou_yuuichi@med.kurume-u.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Goto
authors.forename: Koji
authors.initials: K
authors.lastname: Okuda
authors.forename: Gen
authors.initials: G
authors.lastname: Akasu
authors.forename: Hisafumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D007501:Iron; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011169:Portal Vein / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron