Impact of splenic circulation: non-invasive microbubble-based assessment of portal hemodynamics
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  • 作者:Taro Shimada ; Hitoshi Maruyama ; Takayuki Kondo ; Tadashi Sekimoto…
  • 关键词:Portal hypertension ; Spleen ; Hepatic venous pressure gradient ; Contrast ; enhanced ultrasound
  • 刊名:European Radiology
  • 出版年:2015
  • 出版时间:March 2015
  • 年:2015
  • 卷:25
  • 期:3
  • 页码:812-820
  • 全文大小:1,431 KB
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  • 刊物类别:Medicine
  • 刊物主题:Medicine & Public Health
    Imaging and Radiology
    Diagnostic Radiology
    Interventional Radiology
    Neuroradiology
    Ultrasound
    Internal Medicine
  • 出版者:Springer Berlin / Heidelberg
  • ISSN:1432-1084
文摘
Objective The objective was to examine the effect of splenic circulation using a microbubble agent to assess the severity of portal hypertension. Methods This prospective study consisted of 91 subjects (63.0?±-2.6?years, 30-6; 60 males, 31 females), 62 cirrhosis and 29 controls, who underwent both Doppler ultrasound and contrast-enhanced ultrasound with a perflubutane microbubble agent. Two microbubble-based parameters for splenic circulation, the minimum circulation time (MCT, s) and the peak enhancement time (PET, s), were assessed with respect to the hepatic venous pressure gradient (HVPG) and other clinical findings. Results The MCT and PET showed significant differences between cirrhosis (5.7?±-.8; 14.6?±-.0) and controls (4.0?±-.9, p--.0001; 8.9?±-.3, p--.0001), respectively. However, only PET offered positive correlations with wedged hepatic venous pressure (r--.4648, p--.0001) and HVPG (r--.4573, p--.0001). The area under the receiver operating characteristics curve to identify HVPG?≥-0?mmHg, and 12?mmHg was 0.76 and 0.76, respectively. Conclusions The microbubble-based non-invasive assessment of the splenic circulation is effective to identify the severity of portal hypretension presumably by reflecting congestion of splenic venous flow due to increased portal venous pressure. Key Points -There is a potential link between splenic circulation and portal hypertension. -Microbubble-based assessment of splenic circulation is predictive of the severity of portal hypertension. -Interobserver variability was sufficient in the assessment of splenic enhancement sonograms.
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