Value of Spleen Dynamic Contrast-enhanced Ultrasound Parameters in Predicting Hepatic Vein Pressure Gradient for...

To explore dynamic contrast-enhanced ultrasound (CEUS) parameters in predicting hepatic vein pressure gradient (HVPG) for patients with liver cirrhosis (LC).

Noninvasive diagnosis of HVPG remains a challenge.

This prospective study included patients with LC undergoing hepatic vein catheterization and pressure measurement at the hospital from May 2021 to January 2023. The CEUS images (Mindray Resona R9, 1-6-MHz probe frequency; mechanical index=0.08; image depth=10 cm; focus at the lowest point of the diaphragm; dynamic range=70 dB; optimal gain; single SonoVue bolus injection) were taken for 60 seconds after injection and analyzed using VueBox. HVPG (ie, the gold standard for portal hypertension) was measured routinely by catheterization.

Fifty patients with LC were included in the study. The rise time ( r =0.6, P <0.01), the fall time ( r =0.7, P <0.01), the peak time ( r =0.6, P <0.01), wash-in area under the curve (AUC) ( r =0.5, P <0.01), the wash-out phase AUC ( r =0.4, P <0.01) and wash-in and wash-out phase AUC ( r =0.4, P <0.01) of the dynamic spleen CEUS were positively correlated with HVPG. The optimal fall time cutoff levels to predict HVPG ≥10 mm Hg and ≥12 mm Hg were 27.0 and 36.4 seconds, with the AUC being 0.958 and 0.941, respectively. The optimal area under the wash-in area cutoff level to predict HVPG ≥10 mm Hg and ≥12 mm Hg was 1,658,967.38 (a.u) and 4,244,015.90 (a.u), with the AUC being 0.865 and 0.877, respectively.

The fall time and wash-in AUC obtained by dynamic CEUS may help diagnose HVPG in patients with LC without requiring invasive hepatic vein catheterization.