Primary Clinical Trial Of Hepatic Cirrhosis By Quantitative Analysis Of Contrast-enhanced Ultrasound

Study background:Liver fibrosis and cirrhosis is frequently occurring disease and common diseases in China. Liver fibrosis is a chronic disease that is the most important pathological feature of the progressive development of chronic liver disease of early reversible links. Therefore, if giving early diagnosis and treatment of liver fibrosis, it can significantly improve the prognosis of chronic liver disease. Non-invasive monitoring of liver fibrosis is the current research focus at home and abroad. With the development of acoustic imaging technology, the use of ultrasound contrast agent promise to assess organ perfusion, which can reflect the hepatic fibrosis and cirrhosis of the liver microcirculation and hemo-dynamics to achieve early diagnosis of liver fibrosis and liver hardening purposes.Objective:To use ultrasound imaging to observe the movement in patients with liver, hepatic veins, portal vein and liver parenchyma of the contrast agent perfusion process and the echo intensity changes of liver fibrosis and cirrhosis in patients with ultrasound imaging characteristics of ultrasound contrast for evaluation of liver fibrosis and the quantitative diagnosis of cirrhosis of the liver lesions.Material and Method:30 cases were divided 2 groups. One was normal group (15 cases), the other was patients group with liver cirrhosis (15 cases).30 cases were examined with conventional two-dimensional ultrasound, observed liver morphology, capsule form, and real echo of the traveling hepatic vein, hepatic artery and portal vein and measured the flow rate by pulsed wave ultrasound. Then entered the contrast-enhanced ultrasound conditions, regulated sound power output, mechanical index (Mechanical Index, MI) was 0.08. When injection of contrast agents, built-in timer in ultrasound equipment starting at the same time, real-time dynamic changes were observed in hepatic artery, portal vein, hepatic vein and liver parenchyma. The whole process stored, and then analyzed data by two physicians using QLAB time-intensity curves software. The arriving time (Arriving Time, AT), peak time (Peak Time, PT) and peak intensity (Peak Intensity, PI) of hepatic artery, hepatic vein, portal vein and liver parenchyma were measured. Then, liver-hepatic vein transit time (Hepatic to Hepatic Vein Transit Time, HA-HVTT= HVAT-HAAT), portal vein-hepatic vein transit time (Portal Vein to Hepatic Vein Transit Time, PV-HVTT= HVAT-PVAT), hepatic Artery to Portal vein transit time (Hepatic Artery to Portal Vein Transit Time, HA-PVTT= PVAT-HAAT) were calculated. Results:1. There was no significant difference for HAAT (Hepatic Artery Arriving Time) and PVAT (Portal Vein Arriving Time) between two groups.2. HVAT in cirrhosis group showed significantly shorter than control group (P<0.05). HA-HVTT and PV-HVTT in cirrhosis group were significantly short compared with controls group (P<0.01), HA-PVTT in cirrhosis group were short compared with controls group (P <0.05).3. The peak time of liver parenchyma in cirrhosis group was significantly prolonged compared with control group (P<0.05).4. There were no significant differences for the peak enhancement of hepatic artery, portal vein, hepatic vein and liver parenchyma between two groups.Conclusion:With the development of contrast-enhanced ultrasound, Hepatic Artery Arrive Time, Hepatic transit time and the peak time of liver parenchyma are expected to be applied in non-invasive diagnosis of early cirrhosis.