Abstract
This study aimed to evaluate the feasibility and repeatability of the flash-replenishment method in contrast-enhanced ultrasound (CEUS) perfusion imaging and assess quantitatively microvascular perfusion in the liver. Twenty healthy New Zealand rabbits were submitted to CEUS perfusion imaging with continuous intravenous infusion. Using flash-replenishment kinetics, the dynamic process of depletion and refilling of microbubble contrast agent was recorded. The hepatic microvascular perfusion parameters were calculated, including region of interest, peak intensity (PI), area under the curve (AUC), and hepatic artery to vein transit time (HA-HVTT). A consistency test was performed for multiple measurements by the same operator and blind measurements by two different operators. The hepatic perfusion imaging of 3×108 bubbles/min had minimal error and the best imaging effect and repeatability. The variability of the perfusion parameter measured at 3 cm depth under the liver capsule was at a minimum with coefficient of variation of 3.9%. The interclass correlation coefficient (ICC) of measurements taken by the same operator was 0.985, (95% confidence interval, CI=0.927-0.998). Measurements taken by two operators had good consistency and reliability, with the ICC of 0.948 (95%CI=0.853-0.982). The PI and AUC of liver parenchyma after reperfusion were lower than before blocking; and HA-HVTT was significantly longer than before blocking (P<0.05). The flash-replenishment method in CEUS perfusion imaging showed good stability and repeatability, which provide a valuable experimental basis for the quantitative assessment of hepatic microvascular perfusion in clinical practice.
Highlights
Contrast-enhanced ultrasound (CEUS) perfusion imaging is a noninvasive functional imaging used to assess different pathophysiological and anatomical structures associated with disease through the study of blood flow, metabolism, and changes in the receptors on specific tissues and organs [1,2,3]
The use of microbubble contrast agent as vascular tracer and enhancer allows the functional imaging of hepatic microvascular perfusion before morphological changes of tissues can be detected, which is advantageous compared to traditional ultrasound imaging [5,6,7]
A single operator selected randomly 20 healthy New Zealand rabbits for CEUS perfusion imaging on the same day to measure the peak intensity (PI) of perfusion parameters
Summary
Contrast-enhanced ultrasound (CEUS) perfusion imaging is a noninvasive functional imaging used to assess different pathophysiological and anatomical structures associated with disease through the study of blood flow, metabolism, and changes in the receptors on specific tissues and organs [1,2,3]. The ultrasonic contrast agent containing microbubbles was delivered to tissues and organs through intravenous injection These microbubbles can serve as indicators, helping clinicians monitor changes in microbubble concentration at the same position over time to assess the time-intensity curve (time as x-axis and intensity as y-axis), which can be used to measure the perfusion parameters in different tissues and organs through different injection methods and the fitting of different mathematical models. The use of microbubble contrast agent as vascular tracer and enhancer allows the functional imaging of hepatic microvascular perfusion before morphological changes of tissues can be detected, which is advantageous compared to traditional ultrasound imaging [5,6,7]
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