Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Department of Pathology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Ultrasound Med Biol. 2019 Oct;45(10):2767-2776. doi: 10.1016/j.ultrasmedbio.2019.06.409. Epub 2019 Jul 22.
We aimed to investigate the feasibility of quantitative Sonazoid contrast-enhanced ultrasound (CEUS) in the diagnosis of biliary atresia (BA) at an early disease stage. First, liver tissue from 10 patients with BA and 10 patients with infantile hepatitis syndrome (IHS) was immunostained with cluster of differentiation 68 (CD68) to compare Kupffer cell counts. Then, quantitative Sonazoid CEUS was performed to evaluate the hyperplasia of the artery branches during the artery phase and changes in Kupffer cell counts during the Kupffer phase in a rat model of BA (common bile duct ligation). Based on our results, liver enhancement from Kupffer cells in BA patients was significantly higher than that in IHS patients (p = 0.026 < 0.05). Furthermore, quantitative CEUS showed that the liver enhancement intensity of rats with bile duct ligation was substantially greater than that of rats without bile duct ligation during the artery phase 3 d post-operation and the Kupffer phase 5 d post-operation. The increased enhancement intensity in the Kupffer phase was in agreement with the increase in Kupffer cell counts in pathologic staining (18/20, 90%). In conclusion, quantitative Sonazoid CEUS can detect the hyperplasia of artery branches in artery phase and the increase of Kupffer cells in Kupffer phase in the liver of BA rats at an early disease stage. Therefore, Sonazoid CEUS could potentially be a valuable non-invasive alternative for the diagnosis of BA.
我们旨在探讨定量声诺维超声造影（CEUS）在早期胆道闭锁（BA）诊断中的可行性。首先，对 10 例 BA 患者和 10 例婴儿肝炎综合征（IHS）患者的肝组织进行 CD68 免疫染色，比较枯否细胞计数。然后，对 BA 大鼠模型（胆总管结扎）进行定量声诺维 CEUS，评估动脉期分支动脉增生和枯否细胞计数在库普弗期的变化。根据我们的结果，BA 患者的肝内枯否细胞增强明显高于 IHS 患者（p=0.026<0.05）。此外，定量 CEUS 显示，术后 3 天动脉期和术后 5 天库普弗期结扎胆管的大鼠肝增强强度明显大于未结扎胆管的大鼠。库普弗期增强强度的增加与病理染色中枯否细胞计数的增加一致（18/20，90%）。总之，定量声诺维 CEUS 可以检测到早期 BA 大鼠肝内动脉期分支动脉增生和库普弗期枯否细胞增多。因此，声诺维 CEUS 可能成为诊断 BA 的一种有价值的非侵入性替代方法。
