Quantitative Analysis Of Contrast-enhanced Ultrasonography In Hepatic Ischemia-reperfusion Injury During Perioperative Period Of Partial Hepatectomy With Hepatic Portal Block

Objective: This study aims to explore the feasibility and value of contrast-enhanced ultrasound(CEUS)in non-invasive evaluation of hepatic ischemia reperfusion injury(HIRI)during hepatectomy by using quantitative analysis of contrast-enhanced ultrasonography to monitor the hepatic microcirculation changes during perioperative hepatectomy with hepatic portal block.Method: The 28 patients who were successfully performed liver tumor resection in first affiliated hospital of Guangxi medical university were enrolled in the research.The examinerts were divided into two groups according to whether they were blocked the hepatic portal during the operation: hepatic portal occlusion group and non-hepatic portal occlusion group.Preoperative general data features,intraoperative conditions,and postoperative complications were collected.Contrast-enhanced ultrasound was performed before and 1d,3d,and5 d after surgery.The time-intensity curve(TIC)of CEUS was plotted and the peak intensity(IMAX),rise time(RT),and time to peak(TTP)were measured.At the corresponding time,the patient's peripheral blood was collected and serum aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were detected.Results: There was no significant difference in TIC parameters between the two groups before hepatic portal block(P>0.05).Compared with non-hepatic occlusion group,the IMAX decreased 1 and 3 days after operation in the hepatic portal occlusion group,and RT and TTP prolonged 1 day after surgery(P<0.05).There was no significant difference in RT and TTP 3 days after operation between the two groups.Either each quantification parameter 5day after surgery(P>0.05).There was no significant difference in ALT and AST before hepatic portal block between the two groups(P>0.05).Compared with non-hepatic occlusion group,the ALT decreased 1 and 3 days after operation in the hepatic portal occlusion group,as well as the AST 1 day after operation(P<0.05).There was no significant difference in AST 3 day after operation between the two groups.Either the ALT and AST 5 day after surgery(P>0.05).Pearson correlation analysis showed that contrast-enhanced quantitative parameters had a certain correlations with ALT and AST(P<0.05).Conclusion: Contrast-enhanced ultrasound can be used to monitor the changes of microcirculatory perfusion before and after hepatic portal block and perform objective quantitative analysis,providing another feasible method for clinical evaluation of HIRI after partial hepatectomy.