Chronic liver disease: Correlation of CEUS-based microperfusion and indocyanine green clearance

Abstract

PURPOSE:

To evaluate whether changes of dynamic contrast-enhanced ultrasound (CEUS)-based liver microcirculation during chronic liver disease are correlated with the extent of impaired liver function, expressed by the indocyanine green (ICG) clearance.

MATERIALS AND METHODS:

19 patients underwent CEUS examinations with previous or consecutive ICG clearance test. The ICG plasma disappearance rate (ICG-PDR) was determined using the noninvasive pulse-densitometric LiMON system. Quantification of peak enhancement (PE), rise time (RT) and the wash-in rate (WiR) was performed in the liver parenchyma (ROI_liver) as well as in the portal vein (ROI_{portal vein}) using a novel quantification software (VueBox^TM). To compare quantification parameters, patients were classified in patients representing a healthy population (ICG-PDR >16, n = 8) and those representing patients with liver disease (ICG-PDR ≤16, n = 11).

RESULTS:

ROI_{portal vein} showed significant differences comparing healthy patients and patients with liver disease for all perfusion parameters: PE and WiR were significantly higher in patients without liver disease (p = 0.048; p = 0.039). RT was significantly lower in healthy population (p = 0.039). Comparing perfusion parameters for ROI_liver, PE was significantly higher in patients without liver disease (p = 0.039). There was no significant difference for RT (p = 0.804) and WiR (p = 0.058), respectively.

CONCLUSION:

Within the framework of this study CEUS derived estimation of microcirculation did not prove to be a reliable estimator of liver function. RT, PE and WiR measured in the portal vein were significant perfusion factors in predicting liver function.