title: Washout Ratio in the Hepatic Vein Measured by Contrast-Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs.
abstract: BACKGROUND
  Perflubutane microbubbles, a second-generation ultrasound contrast agent, are phagocytized by Kupffer cells. This characteristic may be useful to differentiate diffuse hepatic diseases in dogs.
  
  
  OBJECTIVE
  To determine whether the washout ratio in the hepatic vein (HV) measured by contrast-enhanced ultrasonography (CEUS) can distinguish between inflammatory and noninflammatory hepatic disorders in dogs.
  
  
  METHODS
  Forty-one client-owned dogs with hepatic disorders including 14 with hepatitis, 7 with primary hypoplasia of the portal vein (PHPV), 9 with congenital portosystemic shunt (cPSS), and 11 with other hepatopathy were enrolled. Six dogs without hepatic disease also were evaluated as healthy controls.
  
  
  METHODS
  Dogs with hepatic disorders were prospectively included. Contrast-enhanced ultrasonography of the HV was performed for 2 minutes. Washout ratio was defined as the attenuation rate from peak intensity to the intensity at the end of the CEUS study.
  
  
  RESULTS
  Washout ratio in the hepatitis group (median, 18.0%; range, 2.0-37.0%) was significantly lower than that of the PHPV (median, 52.2%; range, 11.5-86.3%), cPSS (median, 60.0%; range, 28.6-77.4%), other hepatopathy (median, 70.5%; range, 26.6-88.4%), and normal (median, 78.0%; range, 60.7-91.7%) groups. The area under the receiver operating characteristic curve for hepatitis was 0.960, with a 95% confidence interval (CI) of 0.853-0.990. Washout ratio ≤37.1% resulted in a sensitivity of 100% (95% CI, 78.5-100%) and specificity of 85.2% (95% CI, 67.5-94.1%) for the prediction of hepatitis.
  
  
  CONCLUSIONS
  Washout ratio can distinguish hepatitis from the other noninflammatory disorders with high accuracy. This result might reflect impaired Kupffer cell phagocytosis in dogs with hepatitis.
authors.affiliation: Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: K
authors.identifier: http://orcid.org/0000-0001-8595-4994
authors.initials: K
authors.lastname: Morishita
authors.affiliation: Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Hiramoto
authors.affiliation: Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Michishita
authors.affiliation: Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takagi
authors.affiliation: Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Osuga
authors.affiliation: Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ohta
authors.affiliation: Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Takiguchi
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D003287:Contrast Media / Q000008:administration & dosage*; D004283:Dog Diseases / Q000503:physiopathology*; D004285:Dogs; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006520:Hepatitis, Animal / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007249:Inflammation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000662:veterinary*; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000662:veterinary
chemical_list: D003287:Contrast Media
keywords: Hepatitis; Perflubutane; Portal vein hypoplasia; Portosystemic shunt