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
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
Externí odkaz: