Determination of peripheral color signal density using contrast-enhanced color Doppler ultrasonography in diffuse liver disease.
OBJECTIVE
The study aimed to quantify hepatic vascular changes that accompany the development of chronic liver disease using contrast-enhanced color Doppler ultrasonography and histopathological examination.


METHODS
A series of 62 patients with biopsy-proven chronic liver disease (31 chronic hepatitis, 31 liver cirrhosis) and 8 healthy controls were studied. Altogether, 22 livers (9 chronic hepatitis, 13 liver cirrhosis) obtained at surgery or autopsy were subjected to histopathological examination. Patients with cardiopulmonary disease or intrahepatic tumors were excluded. Intrahepatic color Doppler signals were scanned and counted at the liver surface in a 10 × 30 mm rectangle from liver segment V using color Doppler sonography (SSA 380 A) before and after contrast enhancement with SHU 508A (Levovist). Small arteries 30-1000 µm in diameter were counted on the histopathlogical specimen by microscopy.


RESULTS
The number of color Doppler signals increased significantly after contrast enhancement in both patients and controls. The number of color Doppler signals was elevated before and after contrast enhancement when chronic liver disease was present, especially in cases of Child-Pugh grade C liver cirrhosis. Histologically, more arteries 30-125 µm in diameter were present in patients with chronic hepatitis than in those with liver cirrhosis, whereas more arteries ≦ 125 µm in diameter were present in patients with liver cirrhosis than in those with chronic hepatitis.


CONCLUSIONS
Intrahepatic color Doppler signals are probably derived from peripheral arteries larger than 125 µm in diameter, and the signal density in these arteries increases with progression of the chronic liver disease.
Division of Gastroenterology and Hepatology, Department of Medicine, Toho University, School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan. patho@med.toho-u.ac.jp.
Masao
M
Shinohara
Doppler; contrast enhancement; diffuse liver disease; ultrasonography