Contrast-Enhanced Ultrasound of Liver Cirrhosis
For taking care of patients with liver disease, it is important to understand both the liver histology and the liver test data. Liver biopsy is the most reliable way (gold standard) to know the histology, but invasive. It is also well accepted that the peripheral blood flow within the liver parenchyma is easily influenced by histological changes, such as liver fibrosis, necrosis, edema, and collapse. On the other hand, the liver function is regulated by four main factors, uptake, metabolism, secretion of the liver cells, and liver blood flow. Therefore, analyzing the hemodynamics in the peripheral area of the liver parenchyma may become a relevant way for estimating the histology and the function of the liver. Accordingly, we have studied the significance of the arrival-time parametric image and the perfusion parametric image obtained by Sonazoid®-enhanced ultrasound in diagnosing hepatitis C virus-related chronic liver diseases, especially liver cirrhosis.
As a result, we found analyzing the hepatic microcirculation and the portal vein blood flow by contrast-enhanced ultrasound may be of great help for understanding what is happening within the liver parenchyma in patients with liver cirrhosis.
KeywordsContrast-enhanced ultrasound Liver cirrhosis Liver perfusion Liver hemodynamics
- 1.Reuter SR, Redman HC. Gastrointestinal angiography. Philadelphia: WB Sounders; 1977. p. 306–55.Google Scholar
- 3.Oda M, Kan S, Yokomori H. Regulatory mechanisms of the hepatic microcirculation. In: Miura Y, Itai Y, editors. Macroscopical observation of the hepatic microcirculation and of the characteristic blood flow of the liver tumor. Tokyo: Medical Tribune; 2000. (Japanese).Google Scholar
- 4.Miura Y. Regulatory mechanisms of the portal blood flow observed from the point of point of TAE. In: Miura Y, Itai Y, editors. Macroscopical observation of the hepatic microcirculation and of the characteristic blood flow of the liver tumor. Tokyo: Medical Tribune; 2000. (Japanese).Google Scholar
- 11.Sumino Y, Wakui N, Takayama R, et al. Ultrasonographic diagnosis of the liver diseases. Jpn J Med Ultasonics, 2009. 36:301–18. (Japanese).Google Scholar
- 12.Sumino Y, Takayama R, Nakajima S, et al. Ultrasound of the diffuse liver diseases. Kan-Tan-Sui. 2010;60:395–407. (Japanese).Google Scholar
- 13.Sumino Y, Wakui N, Takayama R. Usefulness of the blood flow analysis with using the contrast enhanced ultrasound in patient with liver disease. INNERVISION. 2011;26:36–8. (Japanese).Google Scholar
- 14.Ichida F, Omata M, Tsuji T, et al. Histopathological diagnostic criterion of the chronic hepatitis. In: Inuyama symposium, Chugai Co., Tokyo; 1996, p. 183–8. (Japanese).Google Scholar
- 16.Wakui N, Takayama R, Kanekawa T, et al. Usefulness of parametric imaging in analyzing the portal blood flow. Jpn J Portal Hypertens. 2012;18:14–8. (Japanese).Google Scholar
- 17.Nakanuma Y, Kouda A, Katayanagi K. Pathology of the idiopathic portal hypertension. Kan-Tan-Sui. 1999;38:35–41. (Japanese).Google Scholar
- 18.Sato Y, Kitamura S, Kitao A, et al. Pathology and pathogenesis of idiopathic portal hypertension. Kan-Tan-Sui. 2010;61:133–40. (Japanese).Google Scholar