The Application Of Parametric Micro-flow Imaging In The Evaluation Of Liver Fibrosis

Purpose: To investigate the application value of parametric micro-flow imaging in theevaluation of liver fibrosis.Materials and methods: From March2013to February2014,117volunteers wererecruited in research prospectively. Ninety-seven patients who were infected byhepatitis B virus (HBV) or/and hepatitis C virus (HCV) and underwent percutaneousultrasound-guided liver biopsy were enrolled into hepatitis group, and20healthyvolunteers were included in control group. Contrast agent, SonoVue, was injected at2ml as a bolus via the antecubital vein. Dynamic images of liver oblique clip plane inthe fifth or sixth intercostal were collected and divided into30seconds group and10seconds group. Then color coding and quantitative analysis were performed andrelated parameters were obtained and analyzed with the stage of liver fibrosis. Ratioof bubble region in30seconds group as the quality control indicator should be above90percent. Otherwise another contrast-enhanced ultrasound would be necessary.Results:(1) Comparison of parameters between the stages of liver fibrosis: the valueof30s-slope reduced and the value of10s-slope increased with the increase of liverfibrosis stage, and there are both statistical differences between the stages of liverfibrosis in each group. The value of30s-ratio at5s and10s-ratio at5s both increasedwith the increase of liver fibrosis stage, and there are both statistical differencesbetween the stages of liver fibrosis in each group.(2) Receiver operatingcharacteristic curve were performed to evaluate the cutoff values and diagnosibility ofparameters to predicting F2and higher or F2and higher of fibrosis stages. a)?F2:when30s-slope?0.062,10s-slope?0.109,30s-ratio at5s?22.00%or10s-ratio at5s?29.05%, the sensitivity, specificity, accuracy, Youden index, positive predictivevalue and negative predictive value are87.2%,84.6%,86.3%,71.8%,91.9%and76.7%;83.3%,74.4%,75.2%,57.7%,78.2%and66.7%;61.5%,74.4%,66.7%,35.9%,83.1%and50.0%;85.9%,89.7%,86.3%,75.6,93.1%and75.6%, respectively. b)?F3: when30s-slope?0.059,10s-slope?0.111,30s-ratio at5s?26.85%or10s-ratioat5s?30.35%, the sensitivity, specificity, accuracy, Youden index, positive predictivevalue and negative predictive value are87.9%,84.7%,86.3%,72.6%,85%and87.7%;89.7%,84.7%,86.3%,74.4%,83.9%and89.1%;62.1%,86.4%,75.2%,48.5%,83.7%and70.3%;89.7%,79.7%,87.2%,69.4%,84.1%and90.7%.Conclusion: Parameters of30s-slope,10s-slope,30s-ratio at5s and10s-ratio at5s arerelated with the severity of liver fibrosis. And parameters of30s-slope,10s-slope and10s-ratio at5s could be the indices to diagnose the severity of liver fibrosis, especiallyfor moderate to severe liver fibrosis. Hence, P-MFI has potential value for guidingantiviral therapy to patients with viral hepatitis and evaluating degree of improvementin liver fibrosis.