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Hepatic arterialization can predict the development of collateral veins in patients with HCV-related liver disease

Noritaka Wakui1, Hidenari Nagai2, Yu Ogino2

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan. noriwakui@yahoo.co.jp.

Journal of Ultrasound
|October 7, 2018
PubMed

Insights

Arrival time parametric imaging (At-PI) effectively predicts collateral vein development in chronic hepatitis C patients. This contrast-enhanced ultrasonography technique shows high diagnostic accuracy for identifying these vascular changes.

Area of Science:

  • Hepatology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Chronic hepatitis C infection (CHC) can lead to liver disease progression and the development of collateral veins.
  • Assessing the progression of liver disease and identifying collateral veins is crucial for managing CHC patients.
  • Conventional methods may have limitations in early detection and precise evaluation of these vascular changes.

Purpose of the Study:

  • To investigate the diagnostic efficacy of Arrival time parametric imaging (At-PI) using contrast-enhanced ultrasonography (CEUS) in predicting the development of collateral veins in CHC patients.
  • To evaluate the accuracy of At-PI in identifying specific collateral vessels such as paraumbilical veins (PV), splenorenal shunts (SRS), and esophageal varices (EV).

Main Methods:

  • A study involving 171 CHC patients who underwent CEUS, upper gastrointestinal (UGI) endoscopy, and liver biopsy.
  • Conventional ultrasound was used to identify potential collateral veins before CEUS.
  • At-PI analysis involved calculating the ratio of red pixels (ROR) in liver segments 5-6 and the right kidney, with Receiver Operating Characteristic (ROC) curves used to assess diagnostic capability.

Main Results:

  • Conventional US identified PV in 2 patients and SRS in 5 patients; UGI endoscopy detected EV in 8 patients.
  • At-PI demonstrated satisfactory diagnostic capability for PV, SRS, and EV.
  • High diagnostic accuracy was achieved for PV (AUROC 0.929) and SRS (AUROC 0.970), with good accuracy for EV (AUROC 0.883).

Conclusions:

  • Evaluation of hepatic arterialization using At-PI is a valuable tool for predicting collateral vein development in CHC patients.
  • At-PI shows significant potential as a non-invasive imaging technique for assessing the risk of portal hypertension complications in CHC.
  • The findings support the utility of At-PI in the management and monitoring of liver disease progression in CHC.
Abstract

Keywords:
Arrival time parametric imagingArterializationCollateral veinContrast-enhanced ultrasonographyEsophageal varicesHepatitis C

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