Quantitative Assessment of Hepatic Fibrosis by Contrast-enhanced Ultrasonography

Objective To explore the contrast-enhanced ultrasonographic features for quantitative assessment of hepatic fibrosis. Methods 86 patients with chronic viral hepatitis B were enrolled in this study from March 2007 to August 2009. The patients were classified into 5 groups （S0-S4） according to fibrosis stage evaluated with ultrasound guided liver biopsy. New contrast-enhanced ultrasonography （CEUS） features including area under the time-intensity curve （TIC） of portal venous phase/hepatic arterial phase （Qp/Qa） and intensity of portal venous phase/hepatic arterial phase （Ip/Ia） were used to detect the blood supply ratio （portal vein/hepatic artery） in each group. Arrival time of portal vein trunk （Tp） and decreasing rate of TIC （β ） were also analyzed. Results Qp/Qa and Ip/Ia decreased from S0 to S4, while Tp and β increased. These 4 features were significantly correlated with the degree of fibrosis （P〈0.001） and were significantly different among the five groups （P〈0.001）. Sensitivity and specificity of Ip/Ia were 80% and 86% for groups ≥S1, 75% and 86% for groups ≥ S2, 71% and 84% for groups ≥ S3, and 76% and 80% for group S4, respectively. Sensitivity and specificity of Qp/Qa were 70% and 88% for groups ≥ S1, 80% and 76% for groups ≥ S2, 74% and 70% for groups ≥ S3, and 81% and 95% for group S4, respectively. Conclusion Ip/Ia and Qp/Qa could be adopted as reliable, non-invasive features for quantitative assessment of hepatic fibrosis.