The Clinical Study Of Contrast-enhanced Ultrasound In The Evaluation Of Liver Fibrosis Degree

Objective：To study the clinical value of contrast-enhancedultrasonography (CEUS) in the evaluation of liver fibrosis degree.Methods: To choose 70 cases of chronic hepatitis patients and healthycontrols 20 cases, In inverse pulse harmonic mode, the ultrasound contrastagents(SonoVue 2.4mL) were by intravenous injection. And the 90scontrast-enhanced ultrasound dynamic image were collected for offlineanalysis. The contrast material to hepatic artery arriving time(HAAT), Portalvein arriving time(PVAT), hepatic vein arriving time(HVAT) and the liverparenchyma enhance peak time(LPEPT) were recored. Intrahepatic transittime was calculated as the difference in arrival time between hepatic arteryand hepatic vein (HA-HVTT), between portal vein and hepatic vein(PV-HVTT), and between parenchyma and hepatic vein(PA-HVTT). 70 casesof chronic hepatitis patients undergoinged the ultrasound-guided liver biopsyin a week after ultrasonic imaging. According to the Scheuer scoring systemfor staging liver fibrosis, according to the liver biopsy pathology of liverfibrosis stage (S0-S4) group. 70 patients with chronic hepatic virus infectionwere divided into mild fibrosis (n=15, S0, S1 period), moderate fibrosis (n=29,S2, S3 period) and cirrhosis (n= 26, S4 period). All the ultrasound imagingparameters(PVAT, HVAT HAAT, LPEPT, HA-HVTT, PV-HVTT, PA-HVTT)were compared with the severity of liver fibrosis.Results: In mild fibrosis group, the arrival time of hepatic vein(28.63±3.14)s was extended(P>0.05). The arrival time of the control group was (26.27±1.74)s. But there was not significant difference between the twogroups(P>0.05). The arrival time of hepatic vein in moderate fibrosis(23.11±1.34) and cirrhosis group (20.56±3.37) were shorter than that of themild fibrosis and the control group. There was a statistically significantdifference among them(P<0.05). The enhance peak of time of the liverparenchyma in moderate fibrosis and cirrhosis groups showed a later onsetthan that of he control group, and there was a significant difference(P<0.05).Their enhanced peak time are (40.53±4.63)s, (46.78±5.56)s, (34.13±2.76)srespectively. The arrival time of the ultrasound contrast material to liverartery, portal vein in three groups had no statistical significance difference.HA-HVTT, PV-HVTT and PA-HVTT in moderate fibrosis and cirrhosisgroups were decreased as the delvelopment of liver fibrosis(P<0.05).Intrahepatic transit times(HA-HVTT，PV-HVTT and PA-HVTT) correlatednegatively with the developmen to fibrosis.Conclusion: The quantitative parameters of contrast-enhancedultrasound, such as the contrast material to hepatic vein arriving time(HVAT),the liver parenchyma enhance peak time(LPEPT), and the intrahepatic transittime(HA-HVTT, PV-HVTT and PA-HVTT) can be used as quantitativeindicators to judge the severity of liver fibrosis, which is value in clinical. Itprovides a new non-invasive diagnosis method to assess the chronic hepatitispatients with liver fibrosis degree, which can better guide clinical treatment.