Visualizing the hepatic vascular architecture using superb microvascular imaging in patients with hepatitis C virus: A novel technique

• Published in: World journal of gastroenterology : WJG 2016-07, Vol.22 (26), p.6057-6064
• Main Authors: Kuroda, Hidekatsu, Abe, Tamami, Kakisaka, Keisuke, Fujiwara, Yudai, Yoshida, Yuichi, Miyasaka, Akio, Ishida, Kazuyuki, Ishida, Hideaki, Sugai, Tamotsu, Takikawa, Yasuhiro
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, CD34 - metabolism; Biopsy; Cohort Studies; disease; Ultrasound; Liver; Female; fibrosi; Hepatitis C, Chronic - diagnostic imaging; Hepatitis C, Chronic - metabolism; Hepatitis C, Chronic - pathology; Humans; imaging; Number; Immunohistochemistry; liver; Liver - blood supply; Liver - diagnostic imaging; Liver - metabolism; Liver - pathology; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - metabolism; Liver Cirrhosis - pathology; Male; microvascular; Microvessels - diagnostic imaging; Middle Aged; Neovascularization, Pathologic - diagnostic imaging; Neovascularization, Pathologic - metabolism; Neovascularization, Pathologic - pathology; Retrospective Cohort Study; Retrospective Studies; ROC Curve; Superb; trees; Chronic; Ultrasonography; vascular
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i26.6057

AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus(HCV) using superb microvascular imaging(SMI) and investigate the use of SMI in the evaluation of liver fibrosis.METHODS: SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees(VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were investigated.RESULTS: There was a significant difference between SMI distribution pattern and fibrosis stage(P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic(AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index(r = 0.617, P < 0.0001).CONCLUSION: SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients.