Hepatic arterialization can predict the development of collateral veins in patients with HCV-related liver disease

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.

Arrival-Time Parametric Imaging in Contrast-Enhanced Ultrasound for Diagnosing Fibrosis in Primary Biliary Cholangitis

“…Obtained At-PI data were evaluated quantitatively, as previously described 12 . Briefly, the ratio of red (ROR) pixel area (shorter arrival times) to the area of all contrast-enhanced pixels was calculated as the ROR, using ImageJ version 1.42 (National Institutes of Health, Bethesda, MD).…”

“…Obtained At-PI data were evaluated quantitatively, as previously described. 11 Brie y, the ratio of red pixel area (shorter arrival times) to the area of all contrast-enhanced pixels was calculated as the ratio of red (ROR), using ImageJ version 1.42 (National Institutes of Health, Bethesda, MD). Higher ROR indicates that the contrast-agent arrival time in the liver is closer to that in the kidney, meaning a wider area of the liver parenchyma received the contrast agent from the arterial route, indicating an arterial-portal shift in the blood ow balance toward arterial dominance in the liver.…”

Short-term Effects of Hepatic Arterial Buffer Responses Induced by Partial Splenic Embolization on the Hepatic Function of Patients with Cirrhosis According to the Child-Pugh Classification

“…In general, the balance of the blood flow between the PV and hepatic artery shifts from portal venous-dominant to hepatic arterialdominant as liver disease progresses. Therefore, the proportion of overall hepatic blood flow represented by the hepatic arterial flow increases as the C-P classification progresses from A to B/C (30,(33)(34)(35). We speculate that different hepatic functional responses to similar treatment approaches may be derived from the original pretreatment hemodynamics of portal venous-hepatic arterial systems based on C-P classification, but not from posttreatment hemodynamic changes caused by PSE-induced HABR.…”

EFSUMB Technical Review – Update 2023: Dynamic Contrast-Enhanced Ultrasound (DCE-CEUS) for the Quantification of Tumor Perfusion

“…An objective and quantitative diagnosis of perfusion characteristics is of particular relevance in the follow-up of cancer patients but can also be used for the diagnostic assessment of other pathological changes associated with alterations in tissue perfusion. This applies, for example, to the noninvasive diagnosis of the progression of parenchymal liver disease, liver cirrhosis, and portal hypertension [10,11,12,13,14,15,16] and for the noninvasive evaluation of chronic kidney disease [17,18,19] and subclinical kidney transplant rejection [17,20,21,22,23,24]. There are partially contradictory data regarding the evaluation of inflammatory activity and response to biologic therapy in inflammatory bowel disease [25,26,27,28,29,30,31,32,33,34].…”