Liver Function Assessment Using Parenchyma-Specific Contrast-Enhanced Ultrasonography

Park, Jae-Hyung; Cho, Jinhan; Kwon, Heejin; Kang, Myongjin; Lee, Sangyun; Roh, Young-Hoon; Kim, Kwan Woo; Lee, Sung Wook

doi:10.1016/j.ultrasmedbio.2015.08.020

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…Recent reports indicated that this low accumulation of contrast agent is caused mainly by decreased phagocytic capacity, and not number of Kupffer cells in animal disease models . Kupffer cell dysfunction has been studied mainly in relation to nonalcoholic steatohepatitis in humans, but similar imaging findings have been reported in patients with cirrhosis resulting from chronic viral hepatitis . Although canine Kupffer cell dysfunction in relation to hepatic disorders has never been reported, impaired phagocytic function of Kupffer cells may have contributed to lower WR in the hepatitis group in our study.…”

Section: Discussionsupporting

confidence: 73%

Washout Ratio in the Hepatic Vein Measured by Contrast‐Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs

Morishita

Hiramoto

Michishita

et al. 2017

Veterinary Internal Medicne

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BackgroundPerflubutane microbubbles, a second‐generation ultrasound contrast agent, are phagocytized by Kupffer cells. This characteristic may be useful to differentiate diffuse hepatic diseases in dogs.Hypothesis/objectivesTo 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.AnimalsForty‐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.MethodsDogs 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.ResultsWashout 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 and Clinical ImportanceWashout ratio can distinguish hepatitis from the other noninflammatory disorders with high accuracy. This result might reflect impaired Kupffer cell phagocytosis in dogs with hepatitis.

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Section: Discussionsupporting

confidence: 73%

Washout Ratio in the Hepatic Vein Measured by Contrast‐Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs

Morishita

Hiramoto

Michishita

et al. 2017

Veterinary Internal Medicne

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“…More recently, Park et al. reported that elimination of Sonazoid ® from the hepatic parenchyma became slower with progression of cirrhotic disease [16]. The application of CEUS to assess hemodynamic changes, as well as liver function, should be investigated in the future.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasonography of the hepatic vein in normal dogs

Morishita

Hiramoto

Osuga

et al. 2016

The Journal of Veterinary Medical Science

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Contrast-enhanced ultrasonography (CEUS) of the hepatic vein can assess intrahepatic hemodynamic changes and has been studied as a noninvasive method to assess the severity of portal hypertension and hepatic fibrosis in humans. However, few reports have described its usefulness in veterinary medicine. The purpose of this study was to characterize CEUS findings of the hepatic vein in normal dogs and assess the repeatability of this method both in a conscious group (n=6) and a sedated group (n=6). Sonazoid® (0.01 ml/kg) was used as a contrast agent, and scanning of the hepatic vein was performed for 2 min. Time-intensity curves were generated from regions of interest in the hepatic vein. Four perfusion parameters were measured for quantitative analysis: hepatic vein arrival time (HVAT), time to peak (TTP), time to peak phase (TTPP) and wash-out ratio (WR). CEUS examinations were performed three times in each dog. The median (range) values of HVAT, TTP, TTPP and WR in the conscious group were 13.5 sec (9–22 sec), 12.5 sec (6–24 sec), 8 sec (6–13 sec) and 78.0% (60.7–91.7%), respectively. Median (range) values of HVAT, TTP, TTPP and WR in the sedated group were 12 sec (8–17 sec), 12.5 sec (9–17 sec), 9 sec (7–13 sec) and 84.1% (63.0–94.4%), respectively. The coefficients of variation of these parameters in the conscious and sedated groups were 7.6–29.7% and 11.8–14.8%, respectively.

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“…Moreover, it can also be used to assess hepatic function in different diseases. For example, in liver cirrhosis, the enhancement curve in a retention rate time of 15 min can be analyzed with good sensitivity (85.7%) and specificity (92.3%) [22].…”

Section: Discussionmentioning

confidence: 99%

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

et al. 2019

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Patient: Male, 59 Final Diagnosis: Amoebic liver abscess Symptoms: Acute abdomen • dispnoea Medication: — Clinical Procedure: Percutaneous CT guided drainage Specialty: Surgery Objective: Rare disease Background: E. histolytica liver abscess results from extra-intestinal diffusion of amebiasis, which is responsible for up 100 000 deaths per annum, placing it second only to malaria in mortality. Currently, the criterion standard for the diagnosis of liver abscesses is ultrasound, but CEUS (contrast-enhanced ultrasound) is emerging as a more accurate method for liver study, and it could be more accurate than ultrasound and non-invasive compared to CT. Case Report: A white man (59 years old) with a 2-day history of dyspnea, acute abdominal pain in right upper quadrant, and raised inflammatory markers was admitted to a second-level Emergency Department in Rome (Italy). He reported several trips to tropical areas many years before, during which he ingested non-potable water and became infected with Entamoeba histolytica . This was treated medically with success. After administration of antibiotics (meropenem and metronidazole), a liver CEUS (contrast-enhanced ultrasonography) with administration of SonoVue (sulphur hexafluoride microbubbles) confirmed a giant liver abscess (15×16 cm). One day later, CT-guided drainage was performed without complications and the patient was discharged on the 25 th post-procedure day, with improved blood results. Conclusions: Acute abdominal pain can be caused by a variety of diseases, but a diagnosis of parasitic abscess should not be overlooked in non-endemic Western countries. CEUS is a new, promising, and more accurate technique that can be utilized to recognize liver abnormalities, including abscesses; however, retrospective population-wide studies are necessary to define the differential diagnoses.

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Liver Function Assessment Using Parenchyma-Specific Contrast-Enhanced Ultrasonography

Cited by 5 publications

References 33 publications

Washout Ratio in the Hepatic Vein Measured by Contrast‐Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs

Washout Ratio in the Hepatic Vein Measured by Contrast‐Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs

Contrast-enhanced ultrasonography of the hepatic vein in normal dogs

Successful Diagnosis of a Longstanding Giant Amoebic Liver Abscess Using Contrast-Enhanced Ultrasonography (CEUS): A Case Report in a Western Country

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