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Titolo:
Non-invasive diagnosis of hepatic cirrhosis by transit-time analysis of anultrasound contrast agent
Autore:
Albrecht, T; Blomley, MJK; Cosgrove, DO; Taylor-Robinson, SD; Jayaram, V; Eckersley, R; Urbank, A; Butler-Barnes, J; Patel, N;
Indirizzi:
FreeGermanyerlin, Klinikum Benjamin Franklin, Dept Radiol, D-12200 Berlin,Free Univ Berlin Berlin Germany D-12200 in, Dept Radiol, D-12200 Berlin, Univ,London Imperial Coll Sci Technol & Med, Hammersmith Hosp, Dept Imaging Univ London Imperial Coll Sci Technol & Med London England Dept Imaging Schering AG, Clin Dev Diagnost, D-1000 Berlin, Germany Schering AG Berlin Germany D-1000 n Dev Diagnost, D-1000 Berlin, Germany
Titolo Testata:
LANCET
fascicolo: 9164, volume: 353, anno: 1999,
pagine: 1579 - 1583
SICI:
0140-6736(19990508)353:9164<1579:NDOHCB>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
LIVER-DISEASE; BLOOD-FLOW; US; ULTRASONOGRAPHY; EXPERIENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Albrecht, T FreeGermanyerlin, Klinikum Benjamin Franklin, Dept Radiol, D-12200 Berlin, Free Univ Berlin Berlin Germany D-12200 iol, D-12200 Berlin,
Citazione:
T. Albrecht et al., "Non-invasive diagnosis of hepatic cirrhosis by transit-time analysis of anultrasound contrast agent", LANCET, 353(9164), 1999, pp. 1579-1583

Abstract

Background Hepatic cirrhosis is accompanied by several haemodynamic changes including arterialisation of the liver, intrahepatic shunts, pulmonary arteriovenous shunts, and a hyperdynamic circulatory state. We postulated that the hepatic first pass of a bolus of an ultrasound contrast agent injected into a peripheral Vein is accelerated in patients with cirrhosis. We investigated this first pass in patients with diffuse liver disease and in normal controls to assess whether it provides useful differential diagnostic information. Methods We enrolled 15 patients with biopsy-proven cirrhosis, 12patients with biopsy-proven non-cirrhotic diffuse liver disease, and 11 normal controls. We carried out continuous spectral doppler ultrasonography of a hepatic vein from 20 s before to 3 min after a peripheral intravenous bolus injection of 2.5 g Levovist. The intensity of the doppler signal was measured and used to plot time-intensity curves. Findings Patients with cirrhosis showed a much earlier onset of enhancement (arrival time; mean 18.3 s) and peak enhancement (mean 55.5 s) than controls (49.8 s and 97.5 s) or patients with non-cirrhotic diffuse liver disease (35.8 s and 79.7 s). All patients with cirrhosis had an arrival time of the bolus of less than 24 s, whereas the arrival time was 24 s or more in 22 of the 23 other participants. Peak enhancement was higher in patients with cirrhosis (mean 48.7 units)than in the other two groups (12.5 and 12.3 units, respectively). We foundhighly significant differences between the patients with cirrhosis and each of the other two groups for all variables (p<0.005), whereas we found no significant differences between non-cirrhotic patients and controls. Interpretation Our preliminary study suggests that analysis of liver transit timeof a bolus of ultrasound contrast agent provides useful information about haemodynamic changes in patients with cirrhosis. Measurement of the arrivaltime of the bolus allows discrimination of patients with cirrhosis from controls and from patients with noncirrhotic diffuse river disease, and has potential as a non-invasive test for cirrhosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 07:42:44