title: Visualizing the hepatic vascular architecture using superb microvascular imaging in patients with hepatitis C virus: A novel technique.
abstract: OBJECTIVE
  To identify the hepatic vascular architecture of patients with hepatitis C virus (HCV) using superb microvascular imaging (SMI) and investigate the use of SMI in the evaluation of liver fibrosis.
  
  
  METHODS
  SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees (VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were investigated.
  
  
  RESULTS
  There was a significant difference between SMI distribution pattern and fibrosis stage (P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic (AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index (r = 0.617, P < 0.0001).
  
  
  CONCLUSIONS
  SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients.
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Tamami
authors.initials: T
authors.lastname: Abe
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kakisaka
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Yudai
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Miyasaka
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sugai
authors.affiliation: Hidekatsu Kuroda, Tamami Abe, Keisuke Kakisaka, Yudai Fujiwara, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Division of Hepatology, Department of Internal Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-8505, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D018952:Antigens, CD34
keywords: CD34; Chronic liver disease; Liver fibrosis; Number of vascular trees; Superb microvascular imaging; Ultrasound