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Effect of obstructive jaundice on hepatic hemodynamics: use of Sonazoid-enhanced ultrasonography in a prospective study of the blood flow balance between the hepatic portal vein and hepatic artery

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Abstract

Purpose

To prospectively clarify the effects of obstructive jaundice (OJ) on hepatic hemodynamics using contrast-enhanced ultrasonography (US).

Methods

Subjects comprised 14 patients admitted to our hospital for OJ between April 2013 and March 2014. Contrast-enhanced US was performed using the LOGIQ E9 ultrasound device during the jaundice phase, before biliary drainage, and again after improvement of jaundice. After injecting the Sonazoid contrast agent, contrast dynamics were recorded in the right kidney and liver segments 5 or 6. Prototype software was used to calculate mean arrival time (AT) of the contrast agent in the liver parenchyma. Statistical analysis was performed to compare the mean AT in the jaundice and improved jaundice phases.

Results

We were unable to follow up three of the 14 patients after biliary drainage; thus, we included 11 patients for further analysis. The mean AT of the contrast agent was 2.0 ± 1.8 and 6.1 ± 2.3 s in the jaundice and improved jaundice phases, respectively, showing significantly shorter AT in the jaundice phase (p = 0.0033).

Conclusion

Our findings indicate that OJ may influence the blood flow balance between the hepatic portal vein and hepatic artery.

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Conflict of interest

Noritaka Wakui, Yuki Takeda, Shuta Nishinakagawa, Nobuo Ueki, Takafumi Otsuka, Nobuyuki Oba, Hiroshi Hashimoto, Naohisa Kamiyama, Yasukiyo Sumino, and Tatsuya Kojima declare that they have no conflict of interest. Noritaka Wakui received research funds for promoting hospital function from the Japan Labour Health and Welfare Organization (No. 220).

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo, Japan

    Noritaka Wakui, Yuki Takeda, Shuta Nishinakagawa, Nobuo Ueki, Takafumi Otsuka, Nobuyuki Oba & Tatsuya Kojima

  2. Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota, Tokyo, 143-8541, Japan

    Noritaka Wakui, Takafumi Otsuka & Yasukiyo Sumino

  3. Ultrasound General Imaging, GE Healthcare, Tokyo, Japan

    Hiroshi Hashimoto & Naohisa Kamiyama

Authors
  1. Noritaka Wakui
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  2. Yuki Takeda
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  3. Shuta Nishinakagawa
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  4. Nobuo Ueki
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  5. Takafumi Otsuka
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  6. Nobuyuki Oba
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  7. Hiroshi Hashimoto
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  8. Naohisa Kamiyama
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  9. Yasukiyo Sumino
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  10. Tatsuya Kojima
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Corresponding author

Correspondence to Noritaka Wakui.

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Wakui, N., Takeda, Y., Nishinakagawa, S. et al. Effect of obstructive jaundice on hepatic hemodynamics: use of Sonazoid-enhanced ultrasonography in a prospective study of the blood flow balance between the hepatic portal vein and hepatic artery. J Med Ultrasonics 42, 513–520 (2015). https://doi.org/10.1007/s10396-015-0629-1

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  • DOI: https://doi.org/10.1007/s10396-015-0629-1

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