Abstract
PurposeArrival time parametric imaging (At-PI) using contrast-enhanced ultrasonography (CEUS) is a procedure for evaluating liver disease progression in chronic hepatitis C infection (CHC). We investigated At-PI diagnostic efficacy in predicting development of collateral veins.MethodsIn total, 171 CHC patients underwent CEUS and upper gastrointestinal (UGI) endoscopy before liver biopsy. Conventional US was performed before CEUS to identify paraumbilical veins (PV) or splenorenal shunts (SRS). After intravenous perflubutane, contrast dynamics of liver segments 5–6 and the right kidney were saved as raw data. At-PI image ratio of red (ROR) pixels to the entire liver was analyzed. Receiver operating characteristic (ROC) curves were generated to investigate the utility of At-PI for collateral vein identification.ResultsConventional US revealed PV in two patients and SRS in five patients; UGI endoscopy detected esophageal varices (EV) in eight patients. Diagnostic capability of At-PI for detecting PV, SRS, and EV was satisfactory, and high for PV and SRS [PV; area under the ROC curve (AUROC) 0.929, cutoff value 77.9%, SRS; AUROC 0.970, cutoff value 82.0%, EV; AUROC 0.883, cutoff value 66.9%].ConclusionsEvaluation of hepatic arterialization by At-PI was useful for predicting collateral vein development in CHC patients.
Highlights
The liver receives dual blood supply from the hepatic portal vein and the hepatic artery
The hepatic portal vein is susceptible to such changes in liver tissue due to the low-pressure system, and blood pressure increases in line with disease progression
In a study by Wakui et al, contrast-enhanced ultrasonography (CEUS) was used to compare the contrast dynamics of the liver with those of the kidney supplied by the renal artery and successfully observed changes in blood balance unique to the liver of patients with chronic hepatitis C infection (CHC) [6]
Summary
The liver receives dual blood supply from the hepatic portal vein and the hepatic artery. Due to the intrinsic low-pressure system, the hepatic portal vein is more susceptible to changes in liver tissue, compared with the hepatic artery. The balance of blood flow between the hepatic artery and portal vein shifts from portal venous dominant to hepatic arterial dominant as liver disease progresses [1,2,3,4], causing complications such as portal hypertension (PH). If diagnostic imaging can be used to visualize and quantify the ever-changing hepatic blood flow during disease progression, it will be possible to monitor the development and onset of liver disease noninvasively, including the complication of PH [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
