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Contrast‐enhanced ultrasonography using Sonazoid to evaluate changes in hepatic hemodynamics in acute liver injury
Author(s) -
Miyazaki Masayuki,
Kato Masaki,
Tanaka Masatake,
Tanaka Kosuke,
Takao Shinichiro,
Kohjima Motoyuki,
Ito Tetsuhide,
Enjoji Munechika,
Nakamuta Makoto,
Kotoh Kazuhiro,
Takayanagi Ryoichi
Publication year - 2011
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06790.x
Subject(s) - medicine , hemodynamics , vein , hepatic veins , ultrasonography , microcirculation , portal vein , arrival time , coagulopathy , radiology , portal venous pressure , liver injury , portal hypertension , cirrhosis , transport engineering , engineering
Background and Aims: Disturbances in hepatic microcirculation are believed to be involved in the mechanisms regulating the progression of acute liver injury (ALI). Evaluation of hepatic hemodynamics in patients with acute liver injury might be helpful in understanding the extent of the intrahepatic microcirculatory disturbances. Therefore, we investigated whether contrast‐enhanced ultrasonography (CEUS) is useful to evaluate the changes in hepatic hemodynamics in patients with ALI. Methods: CEUS was performed in 21 patients with ALI and coagulopathy. Participants were injected with 0.0075 mL Sonazoid/kg body weight, and time‐intensity curves were simultaneously recorded for the hepatic and portal veins. The data were compared with those of 10 healthy volunteers. Results: The arrival time of Sonazoid in the hepatic vein was similar to that in the portal vein in the patients, whereas the arrival time in the hepatic vein was delayed relative to that in the portal vain in the controls (interval between the hepatic and portal vein arrival times, control vs patients 6.74 ± 3.07 s vs 1.13 ± 1.07 s, P < 0.001). Repeated examination revealed that the interval between the hepatic and portal vein arrival times was extended by improvements in hepatic function. The early arrival of Sonazoid in the hepatic vein in the patients is likely to reflect the formation of intrahepatic shunts as a result of hepatic microcirculatory disturbances. Conclusion: CEUS using Sonazoid is a useful method to estimate the changes in hepatic hemodynamics in patients with ALI.