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Contrast-enhanced ultrasonography for the evaluation of liver fibrosis after biliary obstruction

 Hyun Joo Shin  ;  Eun Young Chang  ;  Hye Sun Lee  ;  Jung Hwa Hong  ;  Gyuri Park  ;  Hyun Gi Kim  ;  Myung-Joon Kim  ;  Mi-Jung Lee 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.21(9) : 2614-2621, 2015 
Journal Title
Issue Date
Animals ; Cholestasis/complications* ; Contrast Media* ; Feasibility Studies ; Liver/blood supply* ; Liver/diagnostic imaging* ; Liver Circulation* ; Liver Cirrhosis, Experimental/diagnostic imaging* ; Liver Cirrhosis, Experimental/etiology ; Liver Cirrhosis, Experimental/physiopathology ; Male ; Microcirculation ; Perfusion Imaging/methods* ; Phospholipids* ; Predictive Value of Tests ; Rabbits ; Reproducibility of Results ; Severity of Illness Index ; Sulfur Hexafluoride* ; Time Factors ; Ultrasonography
Animals ; Bile ducts ; Contrast enhanced ultrasound ; Ligation ; Liver cirrhosis ; Rabbits ; Ultrasonography
AIM: To investigate perfusion change in contrast-enhanced ultrasonography (CEUS) to evaluate liver fibrosis based on biliary obstruction using an animal model. METHODS: New Zealand white rabbits (3-4 kg) underwent bile duct ligation to form a biliary obstruction model. We performed liver CEUS and laboratory tests on the day before the operation (day 0) and every 7 postoperative days until the rabbits were sacrificed. After CEUS, signal intensity of liver parenchyma with a time-intensity curve was analyzed. Perfusion parameters were automatically calculated from region-of-interests, including peak signal intensity, mean transit time, area under the curve and time to peak. Histological grades of liver fibrosis were assessed according to the Metavir score system immediately after sacrifice. Generalized estimating equations were used to analyze the association between liver fibrosis grades and perfusion parameters for statistical analysis. The perfusion parameters were measured on the last day and the difference between day 0 and the last day were evaluated. RESULTS: From the nine rabbits, histological grades of liver fibrosis were grade 1 in one rabbit, grade 2 and 3 in three rabbits each, and grade 4 in two rabbits. Among the four CEUS parameters, only the peak signal intensity measured on the last day demonstrated a significant association with liver fibrosis grades (OR = 1.392, 95%CI: 1.114-1.741, P = 0.004). The difference in peak signal intensity between day 0 and the last day also demonstrated an association with liver fibrosis (OR = 1.191, 95%CI: 0.999-1.419, P = 0.051). The other parameters tested, including mean transit time, area under the curve, and time to peak, showed no significant correlation with liver fibrosis grades. CONCLUSION: This animal study demonstrates that CEUS can be used to evaluate liver fibrosis from biliary obstruction using peak signal intensity as a parameter.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Kim, Hyun Gi(김현지)
Park, Gyuri(박규리)
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chang, Eun Young(장은영)
Hong, Jung Hwa(홍정화)
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