Shin Hyun Joo, Chang Eun Young, Lee Hye Sun, Hong Jung Hwa, Park Gyuri, Kim Hyun Gi, Kim Myung-Joon, Lee Mi-Jung
Hyun Joo Shin, Hyun Gi Kim, Myung-Joon Kim, Mi-Jung Lee, Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
World J Gastroenterol. 2015 Mar 7;21(9):2614-21. doi: 10.3748/wjg.v21.i9.2614.
To investigate perfusion change in contrast-enhanced ultrasonography (CEUS) to evaluate liver fibrosis based on biliary obstruction using an animal model.
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.
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.
This animal study demonstrates that CEUS can be used to evaluate liver fibrosis from biliary obstruction using peak signal intensity as a parameter.
利用动物模型研究基于胆道梗阻的对比增强超声（CEUS）灌注变化以评估肝纤维化。
对3 - 4千克的新西兰白兔进行胆管结扎以形成胆道梗阻模型。在手术前一天（第0天）以及术后每7天进行肝脏CEUS检查和实验室检测，直至兔子被处死。CEUS检查后，分析具有时间 - 强度曲线的肝实质信号强度。从感兴趣区域自动计算灌注参数，包括峰值信号强度、平均通过时间、曲线下面积和达峰时间。处死兔子后立即根据梅塔维（Metavir）评分系统评估肝纤维化的组织学分级。使用广义估计方程分析肝纤维化分级与灌注参数之间的关联以进行统计分析。在最后一天测量灌注参数，并评估第0天和最后一天之间的差异。
在9只兔子中，肝纤维化组织学分级为1级的有1只兔子，2级和3级的各有3只兔子，4级的有2只兔子。在四个CEUS参数中，仅最后一天测量的峰值信号强度与肝纤维化分级有显著关联（OR = 1.392，95%CI：1.114 - 1.741，P = 0.004）。第0天和最后一天之间峰值信号强度的差异也与肝纤维化有关联（OR = 1.191，95%CI：0.999 - 1.419，P = 0.051）。测试的其他参数，包括平均通过时间、曲线下面积和达峰时间，与肝纤维化分级无显著相关性。
这项动物研究表明，CEUS可用于以峰值信号强度为参数评估由胆道梗阻引起的肝纤维化。
