Demonstration of intrahepatic accumulated microbubble on ultrasound represents the grade of hepatic fibrosis

Objectives To examine the feasibility of perflubutane-based ultrasound for grading hepatic fibrosis. Methods This prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic ab...

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Veröffentlicht in:European radiology 2012-05, Vol.22 (5), p.1083-1090
Hauptverfasser: Ishibashi, Hiroyuki, Maruyama, Hitoshi, Takahashi, Masanori, Shimada, Taro, Kamesaki, Hidehiro, Fujiwara, Keiichi, Imazeki, Fumio, Yokosuka, Osamu
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container_end_page 1090
container_issue 5
container_start_page 1083
container_title European radiology
container_volume 22
creator Ishibashi, Hiroyuki
Maruyama, Hitoshi
Takahashi, Masanori
Shimada, Taro
Kamesaki, Hidehiro
Fujiwara, Keiichi
Imazeki, Fumio
Yokosuka, Osamu
description Objectives To examine the feasibility of perflubutane-based ultrasound for grading hepatic fibrosis. Methods This prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT 0.5 ]). Results High-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis ( P  
doi_str_mv 10.1007/s00330-011-2346-5
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Methods This prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT 0.5 ]). Results High-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis ( P  &lt; 0.0001). Intensity difference at 15-min phase showed most significant correlation with fibrosis grade ( ρ  = 0.79, P  &lt; 0.0001), and the best areas under the receiver operating characteristic curves are 0.88 for marked fibrosis, 0.95 for advanced fibrosis and 0.97 for cirrhosis, which were significantly higher than those of FIB4, 0.85 for marked fibrosis, 0.89 for advanced fibrosis and 0.90 for cirrhosis. Sensitivity, specificity and efficiency of the intensity difference were 88%, 72% and 81% for marked fibrosis, 85%, 91% and 89% for advanced fibrosis and 97%, 90% and 91% for cirrhosis, respectively. The subsequent study validated the main study results; significant correlation between the intensity difference and the fibrosis grade ( ρ  = 0.73–0.77, P  &lt; 0.0001). Conclusions Perflubutane-based ultrasound accurately predicts the grade of hepatic fibrosis. Key Points • The behaviour of intrahepatic microbubbles depends on the severity of hepatic fibrosis . • Layer enhancement pattern simply represents the degree of chronic liver disease . • Parenchymal intensity change due to high-power emission predicts the hepatic fibrosis grade .</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-011-2346-5</identifier><identifier>PMID: 22207268</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Age ; Aged ; Biopsy ; Cirrhosis ; Contrast Media - pharmacokinetics ; Diagnostic Radiology ; Feasibility Studies ; Female ; Ferric Compounds - pharmacokinetics ; Fibrosis ; Fluorocarbons - pharmacokinetics ; Hepatitis ; Hepatobiliary-Pancreas ; Humans ; Image Interpretation, Computer-Assisted - methods ; Imaging ; Internal Medicine ; Interventional Radiology ; Iron - pharmacokinetics ; Liver cirrhosis ; Liver Cirrhosis - diagnostic imaging ; Liver diseases ; Medicine ; Medicine &amp; Public Health ; Microbubbles ; Middle Aged ; Neuroradiology ; Oxides - pharmacokinetics ; Platelets ; Radiology ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; Ultrasonic imaging ; Ultrasonography - methods ; Ultrasound ; Young Adult</subject><ispartof>European radiology, 2012-05, Vol.22 (5), p.1083-1090</ispartof><rights>The Author(s) 2011</rights><rights>European Society of Radiology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c567t-446d9f47df0921819e58fb1d5d10dd970006afa7e5a70e1a058b97d9ef36a663</citedby><cites>FETCH-LOGICAL-c567t-446d9f47df0921819e58fb1d5d10dd970006afa7e5a70e1a058b97d9ef36a663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-011-2346-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-011-2346-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22207268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishibashi, Hiroyuki</creatorcontrib><creatorcontrib>Maruyama, Hitoshi</creatorcontrib><creatorcontrib>Takahashi, Masanori</creatorcontrib><creatorcontrib>Shimada, Taro</creatorcontrib><creatorcontrib>Kamesaki, Hidehiro</creatorcontrib><creatorcontrib>Fujiwara, Keiichi</creatorcontrib><creatorcontrib>Imazeki, Fumio</creatorcontrib><creatorcontrib>Yokosuka, Osamu</creatorcontrib><title>Demonstration of intrahepatic accumulated microbubble on ultrasound represents the grade of hepatic fibrosis</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives To examine the feasibility of perflubutane-based ultrasound for grading hepatic fibrosis. Methods This prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT 0.5 ]). Results High-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis ( P  &lt; 0.0001). Intensity difference at 15-min phase showed most significant correlation with fibrosis grade ( ρ  = 0.79, P  &lt; 0.0001), and the best areas under the receiver operating characteristic curves are 0.88 for marked fibrosis, 0.95 for advanced fibrosis and 0.97 for cirrhosis, which were significantly higher than those of FIB4, 0.85 for marked fibrosis, 0.89 for advanced fibrosis and 0.90 for cirrhosis. Sensitivity, specificity and efficiency of the intensity difference were 88%, 72% and 81% for marked fibrosis, 85%, 91% and 89% for advanced fibrosis and 97%, 90% and 91% for cirrhosis, respectively. The subsequent study validated the main study results; significant correlation between the intensity difference and the fibrosis grade ( ρ  = 0.73–0.77, P  &lt; 0.0001). Conclusions Perflubutane-based ultrasound accurately predicts the grade of hepatic fibrosis. 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Methods This prospective study included 202 subjects; main study (controls:33, F0–1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0–1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT 0.5 ]). Results High-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis ( P  &lt; 0.0001). Intensity difference at 15-min phase showed most significant correlation with fibrosis grade ( ρ  = 0.79, P  &lt; 0.0001), and the best areas under the receiver operating characteristic curves are 0.88 for marked fibrosis, 0.95 for advanced fibrosis and 0.97 for cirrhosis, which were significantly higher than those of FIB4, 0.85 for marked fibrosis, 0.89 for advanced fibrosis and 0.90 for cirrhosis. Sensitivity, specificity and efficiency of the intensity difference were 88%, 72% and 81% for marked fibrosis, 85%, 91% and 89% for advanced fibrosis and 97%, 90% and 91% for cirrhosis, respectively. The subsequent study validated the main study results; significant correlation between the intensity difference and the fibrosis grade ( ρ  = 0.73–0.77, P  &lt; 0.0001). Conclusions Perflubutane-based ultrasound accurately predicts the grade of hepatic fibrosis. Key Points • The behaviour of intrahepatic microbubbles depends on the severity of hepatic fibrosis . • Layer enhancement pattern simply represents the degree of chronic liver disease . • Parenchymal intensity change due to high-power emission predicts the hepatic fibrosis grade .</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22207268</pmid><doi>10.1007/s00330-011-2346-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; SpringerNature Journals
subjects Age
Aged
Biopsy
Cirrhosis
Contrast Media - pharmacokinetics
Diagnostic Radiology
Feasibility Studies
Female
Ferric Compounds - pharmacokinetics
Fibrosis
Fluorocarbons - pharmacokinetics
Hepatitis
Hepatobiliary-Pancreas
Humans
Image Interpretation, Computer-Assisted - methods
Imaging
Internal Medicine
Interventional Radiology
Iron - pharmacokinetics
Liver cirrhosis
Liver Cirrhosis - diagnostic imaging
Liver diseases
Medicine
Medicine & Public Health
Microbubbles
Middle Aged
Neuroradiology
Oxides - pharmacokinetics
Platelets
Radiology
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Ultrasonic imaging
Ultrasonography - methods
Ultrasound
Young Adult
title Demonstration of intrahepatic accumulated microbubble on ultrasound represents the grade of hepatic fibrosis
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