使用对比增强超声检查分析门静脉时间-强度曲线斜率梯度对代偿期肝硬化进行无创诊断。

Noninvasive diagnosis of compensated cirrhosis using an analysis of the time-intensity curve portal vein slope gradient on contrast-enhanced ultrasonography.

作者信息

Goto Yuichi, Okuda Koji, Akasu Gen, Kinoshita Hisafumi, Tanaka Hiroyuki

机构信息

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 8300011, Japan,

出版信息

Surg Today. 2014 Aug;44(8):1496-505. doi: 10.1007/s00595-013-0750-y. Epub 2013 Oct 18.

DOI:10.1007/s00595-013-0750-y

PMID:24136649

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4097203/

Abstract

PURPOSE

We measured the slope gradients (SGs) of the vascular time-intensity curves (TICs) of the intrahepatic vessels on contrast-enhanced ultrasonography (CEUS). The aim of this study was to assess the diagnostic accuracy of the SG of each hepatic vessel, particularly the portal vein (PV), for detecting cirrhosis and to compare this method with conventional modalities.

METHODS

Fifty-one preoperative patients underwent CEUS, and the TICs were plotted. The SGs of the hepatic artery, PV and hepatic vein were obtained from the linear functions between the slope of the arrival time of the contrast agent and the peak enhancement time of each vessel. The transit times and levels of biochemical markers were also measured. The patients were divided into three groups according to the Metavir score: F0/1 group (n = 14), F2/3 group (n = 21) and F4 group (n = 16).

RESULTS

The PVSG significantly decreased in the F4 group (F0/1: 29.1 ± 2.27, F2/3: 23.1 ± 1.86, F4: 14.7 ± 2.13). The PVSG demonstrated high accuracy for diagnosing cirrhosis and was correlated with the levels of ICG-R15 and hyaluronic acid (Spearman rank correlation; ρ = -0.5691, p < 0.001 and ρ = -0.4652, p = 0.0006).

CONCLUSIONS

The PVSG has the potential to be a diagnostic marker for identifying patients with well-compensated cirrhosis.

摘要

目的

我们在超声造影（CEUS）上测量了肝内血管的血管时间-强度曲线（TICs）的斜率梯度（SGs）。本研究的目的是评估各肝血管，特别是门静脉（PV）的SG在检测肝硬化方面的诊断准确性，并将该方法与传统方式进行比较。

方法

51例术前患者接受了CEUS检查，并绘制了TICs。肝动脉、PV和肝静脉的SGs通过造影剂到达时间斜率与各血管峰值增强时间之间的线性函数获得。还测量了转运时间和生化标志物水平。根据梅塔维评分将患者分为三组：F0/1组（n = 14）、F2/3组（n = 21）和F4组（n = 16）。

结果

F4组的门静脉SG显著降低（F0/1：29.1±2.27，F2/3：23.1±1.86，F4：14.7±2.13）。门静脉SG在诊断肝硬化方面具有较高的准确性，并且与吲哚菁绿滞留率15（ICG-R15）和透明质酸水平相关（斯皮尔曼等级相关；ρ = -0.5691，p < 0.001和ρ = -0.4652，p = 0.0006）。