Anderloni, A.; MacQuarrie, J.; Leen, E.; Oein, K.; Angerson, W.J.; Morris, A.J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA3
Academic Journal
Background: It has been previously shown that alterations in hepatic haemodynamics can be assessed in cirrhotic patients by measuring the hepatic vein transit time of an ultrasound contrast agent. Aim: To evaluate the clinical usefulness of a new contrast agent SonoVue, in differentiating between patients with cirrhosis, hepatitis C and normal subjects. Methods-We studied 13 healthy controls, 14 subjects with biopsy proven hepatitis C and 18 subjects with proven cirrhosis, using a Philips-ATL 5000 scanner with a 3.5 MHZ curvilinear scanhead. An intercostal scan including the hepatic vein (HV), the hepatic artery (HA), and the portal vein (PV) was selected. Colour-Doppler gain was reduced until no signal was displayed and MI was set at 0.8. A bolus injection of 1 mi SonoVue was given. The transit time, defined as the time interval in seconds between the start of the injection and first appearance of colour-Doppler signal in the vessel, was recorded For the HA, HV, and PV. The "lntrahepatic time index" (ITI) was defined as the difference between the HV arrival time and the HA arrival time. Each scan was recorded on SVHS tape for offline review. Results: Overall differences between groups were significant for all variables (p < 0.001). Pairwise differences between the cirrhotic group and each of the other two groups were all statistically significant (p < 0.05), and those between the hepatitis C group and controls were significant for all variables except HA (p < 0.05). An ITl 9 sec showed a sensitivity of 0.90 in detecting cirrhosis, and specificities of 0.93 and 1.00 in distinguishing cirrhosis from hepatitis and controls respectively. An ITl between 9 and 13 sec showed a sensitivity of 0.64 and specificity of 0.90 in distinguishing hepatitis from the other groups. Conclusion: ITl is accurate in detecting cirrhosis and may be useful in identifying hepatitis C patients with underlying.


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