Contrast‐Enhanced Sonography for Quantitative Assessment of Portal Hypertension in Patients With Liver Cirrhosis

• Published in: Journal of ultrasound in medicine 2014-11, Vol.33 (11), p.1971-1977
• Main Authors: Qu, En-Ze, Zhang, Ying-Cai, Li, Zhi-Yan, Liu, Yang, Wang, Jin-Rui
• Format: Article
• Language: English
• Subjects: Adult; Blood Pressure Determination - methods; Contrast Media; contrast-enhanced sonography; Feasibility Studies; gastrointestinal ultrasound; Humans; Hypertension, Portal - diagnostic imaging; Hypertension, Portal - etiology; Hypertension, Portal - physiopathology; Image Interpretation, Computer-Assisted - methods; Liver Cirrhosis - complications; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - physiopathology; Male; Middle Aged; noninvasive; Phospholipids; portal hypertension; Reproducibility of Results; Sensitivity and Specificity; Sulfur Hexafluoride; Ultrasonography - methods; Venous Pressure
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.33.11.1971

Objectives The clinical utility of contrast‐enhanced sonography in portal hypertension remains unclear. We explored the feasibility of using contrast‐enhanced sonography for noninvasive assessment of portal venous pressure. Methods Twenty healthy individuals (control group; 9 men; mean age, 46.4 years) and 18 patients with portal hypertension (15 men; mean age, 46.2 years) were enrolled in this study. The portal hypertension group included patients who underwent splenectomy and pericardial blood vessel disarticulation at our hospital from October 2010 to March 2011. One week before surgery, patients with portal hypertension underwent preoperative liver contrast‐enhanced sonography. Two‐dimensional, Doppler, and contrast‐enhanced sonographic parameters were compared between the groups. Portal venous pressure was measured intraoperatively by portal vein puncture in the portal hypertension group, and its relationship with the other parameters was analyzed. Results The 2‐dimensional, Doppler, and contrast‐enhanced sonographic parameters differed between the groups (P < .01). Portal venous pressure was inversely correlated with the area under the portal vein/hepatic artery time‐intensity curve ratio (Qp/Qa), portal vein/hepatic artery strength ratio (Ip/Ia), and portal vein/hepatic artery wash‐in perfusion slope ratio (βp/βa), with correlation coefficients of −0.701, −0.625, and −0.494, respectively. Conclusions Measurement of the liver contrast‐enhanced sonographic parameters Qp/Qa, Ip/Ia, and βp/βa could be used as a new quantitative method for noninvasively assessing portal venous pressure.