Liver fibrosis staging with contrast-enhanced ultrasonography: prospective multicenter study compared with METAVIR scoring

Abstract

We prospectively assessed contrast-enhanced sonography for evaluating the degree of liver fibrosis as diagnosed via biopsy in 99 patients. The transit time of microbubbles between the portal and hepatic veins was calculated from the difference between the arrival time of the microbubbles in each vein. Liver biopsy was obtained for each patient within 6 months of the contrast-enhanced sonography. Histological fibrosis was categorized into two classes: (1) no or moderate fibrosis (F0, F1, and F2 according to the METAVIR staging) or (2) severe fibrosis (F3 and F4). At a cutoff of 13 s for the transit time, the diagnosis of severe fibrosis was made with a specificity of 78.57%, a sensitivity of 78.95%, a positive predictive value of 78.33%, a negative predictive value of 83.33%, and a performance accuracy of 78.79%. Therefore, contrast-enhanced ultrasound can help with differentiation between moderate and severe fibrosis.

Intrahepatic Transit Time Predicts Liver Fibrosis in Patients with Chronic Hepatitis B: Quantitative Assessment with Contrast-Enhanced Ultrasonography

“…In our study, the hepatic vein arrival time gradually decreased with the severity of fibrosis, as reported in the literature most based on the patients with chronic hepatitis C (Albrecht et al 1999;Hirota et al 2005;Lim et al 2006;Sugimoto et al 2002), but significant changes were found only when cirrhosis was present; the hepatic artery and portal vein arrival times were not significantly changed with the progress of liver fibrosis. In contrast, intrahepatic transit times (HA-HVTT and PV-HVTT) decreased with the progression of fibrosis, consistent with the literature (Pedersen et al 2005;Abbattista et al 2008;Staub et al 2009) and were significantly correlated with the stages of liver fibrosis. PV-HVTT even became a negative number in some cirrhotic patients.…”

Diagnostic Accuracy of Hepatic Vein Arrival Time Performed with Contrast-Enhanced Ultrasonography for Cirrhosis: A Systematic Review and Meta-Analysis

“…All liver biopsies were performed by skilled doctors, and the basic principles of biopsy were faithfully assured. Seven studies used a Siemens Sequoia ultrasound system (Siemens Healthcare, Erlangen, Germany) 13,27,28,31–33,35. GE Logiq system (General Electric Healthcare, Milwaukee, WI, USA) was used in two of the studies,26,34 while a Toshiba system (Toshiba Corporation, Tokyo, Japan) was used in two other studies 29,30.…”

“…With regard to contrast, there were five studies13,27,28,32,33 that used Levovist, the first-generation contrast agent. Six studies26,29,31,33–35 used the second-generation SonoVue. Sonazoid and Definity (Lantheus Medical Imaging, North Billerica, MA, USA) were each used in one study 30,36.…”

Evaluation of regional hepatic perfusion (RHP) by contrast-enhanced ultrasound in patients with cirrhosis

“…Transit time is shortened in patients with chronic liver disease/cirrhosis in comparison with healthy subjects [38]. However, TT does not strictly estimate perfusion, and it has not been compared with more accurate methods.…”