Severe Portal Hypertension in Cirrhosis: Evaluation of Perfusion Parameters with Contrast-Enhanced Ultrasonography

Title
Severe Portal Hypertension in Cirrhosis: Evaluation of Perfusion Parameters with Contrast-Enhanced Ultrasonography
Author
손주현
Keywords
DEGUM MULTICENTER TRIAL; TRANSIT-TIME ANALYSIS; FOCAL LIVER-LESIONS; VEIN WAVE-FORM; HEPATITIS-C; HEPATOCELLULAR-CARCINOMA; HEPATOPULMONARY SYNDROME; DOPPLER SONOGRAPHY; ULTRASOUND CEUS; DAMPING INDEX
Issue Date
2015-03
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v. 10, NO 3, Page. 601-614
Abstract
Objective To investigate the role of contrast-enhanced ultrasonography (CEUS) and Doppler ultrasonography (DUS) in the diagnosis of severe portal hypertension (PH) in patients with liver cirrhosis (LC). Methods Patients with PH scheduled to receive hepatic venous pressure gradient (HVPG) measurement were recruited for this study. Hepatic DUS and CEUS were performed successively. Several Doppler and CEUS parameters were explored for correlation with HVPG values and their association with severe PH (˃= 12 mmHg of HVPG). Comparison of the parameters between the severe and non-severe PH groups and their correlation with HVPG values was evaluated. A receiver operating characteristic (ROC) curve analysis was also performed to investigate the performance in order to diagnose severe PH. Results Fifty-three consecutive patients were enrolled in this study. Among them, 43 patients did not have significant ascites. Compared with the non-severe PH group, portal venous velocity and intrahepatic transit time (ITT) were significantly reduced in the severe PH group (all p˂0.05). Difference between inspiratory and expiratory hepatic venous damping indices (.HVDI), hepatic venous arrival time (HVAT) and ITT moderately correlated with HVPG (r = -0.358, -0.338, and -0.613, respectively). Areas under the curves for severe PH were 0.94 of ITT and 0.72 of HVAT, respectively (all p˂0.05). ITT under 6 seconds indicated severe PH with a sensitivity of 92% and a specificity of 89%. Conclusions Hepatic CEUS may be more useful in estimating the HVPG value and determining the presence of severe PH compared to DUS, and ITT was the most accurate parameter to diagnose severe PH.
URI
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0121601http://hdl.handle.net/20.500.11754/22736
ISSN
1932-6203
DOI
10.1371/journal.pone.0121601
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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