Contrast‐Enhanced Ultrasonography–Based Hepatic Perfusion for Early Prediction of Prognosis in Acute Liver Failure
Autor: | Yudai Fujiwara, Keisuke Kakisaka, Tomoaki Nagasawa, Yasuhiro Takikawa, Tamami Abe, Hidekatsu Kuroda, Yuji Suzuki |
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Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Perfusion Imaging medicine.medical_treatment Contrast Media Liver transplantation Severity of Illness Index 03 medical and health sciences Liver disease Blood Circulation Time 0302 clinical medicine Japan Predictive Value of Tests Massive Hepatic Necrosis Internal medicine medicine Humans Prospective Studies Vein Hepatology Receiver operating characteristic business.industry Ultrasound Reproducibility of Results Ultrasonography Doppler Original Articles Liver Failure/Cirrhosis/Portal Hypertension Liver Failure Acute Image Enhancement Prognosis medicine.disease Survival Analysis 030104 developmental biology medicine.anatomical_structure Liver Cardiology Original Article 030211 gastroenterology & hepatology business Perfusion Liver Circulation Artery |
Zdroj: | Hepatology (Baltimore, Md.) |
ISSN: | 1527-3350 0270-9139 |
Popis: | Background and Aims Acute liver failure (ALF) is a rare but dramatic clinical syndrome characterized by massive hepatic necrosis leading to multiorgan failure. It is difficult to predict the outcomes in patients with ALF using existing prognostic models. We aimed to analyze hepatic perfusion using contrast‐enhanced ultrasound and Doppler ultrasound in patients with ALF and investigate its utility as a prognostic biomarker. Approach and Results In this prospective observational study, 208 patients with acute liver injury/ALF were enrolled from 2015 to 2019. We evaluated 50 consecutive patients with ALF with Doppler ultrasound and contrast‐enhanced ultrasound performed on admission. The cases were divided into the following two groups: survivors (recovered without surgical intervention) and nonsurvivors (died of ALF or underwent liver transplantation). The time to peak and peak intensity of hepatic artery, portal vein, hepatic vein, and liver parenchyma were calculated using the time‐intensity curve analysis. The hepatic artery (HA) resistive index was calculated using the fast Fourier transform analysis of Doppler ultrasound. The time interval (TI) between the time to peak of HA and liver parenchyma (LP) was significantly shorter in the nonsurvivors than in the survivors (P |
Databáze: | OpenAIRE |
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