BACKGROUND/AIMS: To evaluate the enhancement patterns of liver metastases and their influencing factors using dynamic contrast-enhanced ultrasound (CEUS). METHODS: A total of 240 patients (139 male and 101 female; 58.5±11.2 years of age) diagnosed with liver metastases in our hospital were enrolled in this study to evaluate tumor characteristics using CEUS. A comparison of enhancement patterns with tumor size and primary tumor type was performed using the chi-square test. The differences between quantitative variables were evaluated with the independent-sample t-test and one-way analysis of variance. RESULTS: The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous hyperenhancement (133/240, 55.4%), rim-like hyperenhancement (80/240, 33.3%), heterogeneous hyperenhancement (10/240, 4.2%), and isoenhancement (17/240, 7.1%). There were significant differences in the enhancement patterns during the arterial phase based on the nodule size (p=0.001). A total of 231 of the nodules showed complete washout during the portal phase, and 237 nodules were hypoenhanced during the delayed phase. The washout time was correlated with tumor vascularity, with a longer washout time observed in hypervascular metastases compared to hypovascular metastases (p=0.033). CONCLUSIONS: Diffuse homogeneous hyperenhancement followed by rapid washout was the most common enhancement pattern of liver metastases on CEUS and was affected by the nodule size and tumor vascularity. Small metastases were prone to show diffuse homogeneous hyperenhancement. Hyper-vascular metastases showed a significantly longer washout time compared to hypovascular metastases.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Contrast Media/*therapeutic use ; Female ; Humans ; Liver/diagnostic imaging/pathology ; Liver Neoplasms/blood supply/*diagnostic imaging/secondary ; Male ; Middle Aged ; Neovascularization, Pathologic/diagnostic imaging ; Ultrasonography/*methods ; Young Adult

OBJEVTIVETo explore the feasibility and reliability of ultrasonic monitoring of portal vein (PV) and hepatic vein (HV) blood flow volume changes in the process of induced carcinogenesis of hepatocellular carcinoma and the correlation of PV/HV blood flow volume ratio (Qpv/Qhv) with the severity of liver cirrhosis.

METHODSSD rats with diethylnitrosamine-induced liver carcinogenesis underwent regular liver ultrasound examinations including color flow imaging and pulsed Doppler examination. The main PV and HV blood flow parameters were measured to calculate Qpv/Qhv until successful induction of liver cancer.

RESULTSThe PV diameter increased significantly with the severity of liver cirrhosis in the rats (P<0.05), and the PV blood flow velocity reduced but the blood flow volume increased significantly in liver cancer and cirrhosis stages (P<0.05). Normal hepatic vein blood flow was significantly greater than that measured in liver cirrhosis and hepatocellular carcinoma stages. The Qpv/Qhv measured in normal rats was significantly lower than that in liver cirrhosis and liver cancer stages, but the ratios were comparable between the latter two stages.

CONCLUSIONUltrasonography is reliable to monitor the change of liver hemodynamics in rats with induced liver carcinogenesis, in which the changes of Qpv/Qhv are correlated with the severity of liver cirrhosis.

Animals ; Blood Flow Velocity ; Blood Volume ; Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Hemodynamics ; Hepatic Veins ; Liver Cirrhosis ; diagnostic imaging ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Portal Vein ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Ultrasonography

Congenital extrahepatic portocaval shunt (CEPS) is a rare anomaly of the mesenteric vasculature in which the intestinal and splenic venous drainage bypasses the liver and drains directly into the inferior vena cava, the left hepatic vein or the left renal vein. This uncommon disease is frequently associated with other malformations and mainly affects females. Here we report a case of pulmonary arterial hypertension associated with CEPS (Abernethy type 1b shunt) in a 20-yr-old man who was incidentally diagnosed during evaluation of multiple nodules of the liver. The patient was treated by inhalation of iloprost (40 microg/day) with improved condition and walking test. Physicians should note that congenital portocaval shunt may cause pulmonary hypertension.
Echocardiography, Doppler ; Humans ; Hypertension, Pulmonary/*diagnosis/drug therapy ; Iloprost/therapeutic use ; Liver/blood supply/radiography ; Magnetic Resonance Imaging ; Male ; Thoracic Arteries/ultrasonography ; Tomography, X-Ray Computed ; Vasodilator Agents/therapeutic use ; Vena Cava, Inferior/*abnormalities/ultrasonography ; Young Adult

OBJECTIVETo explore the feasibility of establishing an isolated porcine liver machine perfusion model and assess its value in high-intensity focused ultrasound studies.

METHODSTwenty-one isolated porcine livers were perfused with autologous blood for 4 h through dual vessels (portal vein and hepatic artery) cannulation using an extracorporeal circulation machine under a sub-normothermic perfusion condition. The perfusion model was assessed by monitoring the liver color, texture, liver weight gain, hemodynamic parameters, color Doppler flow imaging, bile output and histopathology.

RESULTSNineteen isolated porcine livers were successfully cannulated with dual vessels, and failure of hepatic artery intubation occurred in two porcine livers. After machine perfusion for 4 h, the isolated livers maintained a soft texture with stable hemodynamic levels within relative normal physiological ranges. The bile output was more than 3 ml/h within the initial 3 h of perfusion. Histopathological examination demonstrated no morphological or structural changes of the liver tissues.

CONCLUSIONThe isolated porcine liver perfusion model is stable and feasible, and can be used for high-intensity focused ultrasound studies.

Animals ; Equipment Design ; Extracorporeal Circulation ; instrumentation ; methods ; Hemodynamics ; Liver ; blood supply ; diagnostic imaging ; Liver Circulation ; physiology ; Swine ; Ultrasonography

OBJECTIVETo assess the feasibility of usage of microbubbles conjugated with RGD peptides and contrast enhanced ultrasound (CEU) in detection of tumor angiogenesis.

METHODSLipid microbubbles (MB) were prepared, and the RGD peptides were covalently conjugated to the lipid shell of MB (MB(RGD)). Six nude mice with tumor created by dorsal inoculation of HepG2 tumor cells were used as the test group. Six nude mice without tumor were served as the control group. 10 minutes after bolus injection of MB and MB(RGD) randomly (30 min interval) via a tail vein catheter, CEU was performed on the tumors of the test group and the thigh skeletal muscles of control group. The video intensity (VI) of tumors and the skeletal muscles were measured. The tumors and the skeletal muscles were harvested for immunohistochemical examination.

RESULTSOnly a slight contrast enhancement of the tumor was seen with MB, and the VI was 5.33 ± 1.71. While a remarkable enhancement of the tumor was observed after injection of MB(RGD). The VI was up to 17.03 ± 3.58, 3.18 folds higher as compared with that obtained by injection of MB (P < 0.05). As expected, there were no obvious contrast enhancement of the skeletal muscles with both MB(RGD) and MB. There was a high expression of αvβ3-integrin in tumor neovascular endothelium, however, no apparent expression of αvβ3-integrin was observed in the skeletal muscle vascular endothelium.

CONCLUSIONCEU with MB(RGD) can be used to effectively evaluate the angiogenesis of tumors, and it may greatly contribute to the early judgement of the nature of tumor.

Animals ; Cell Line, Tumor ; Contrast Media ; Endothelium, Vascular ; diagnostic imaging ; metabolism ; Female ; Humans ; Integrin alphaVbeta3 ; metabolism ; Liver Neoplasms ; blood supply ; diagnostic imaging ; metabolism ; pathology ; Male ; Mice ; Mice, Nude ; Microbubbles ; Muscle, Skeletal ; blood supply ; Neoplasm Transplantation ; Neovascularization, Pathologic ; diagnostic imaging ; metabolism ; pathology ; Oligopeptides ; Ultrasonics ; methods ; Ultrasonography

OBJECTIVETo investigate the feasibility of evaluating hepatic blood perfusion after liver transplantation using color Doppler and contrast-enhanced ultrasonography and the diagnostic value of hepatic blood perfusion for acute graft rejection.

METHODIn this before-after study with quantitative analysis, contrast-enhanced sonography was performed with simultaneous liver function monitoring in porcine models of allograft liver transplantation before and after the operation.

RESULTSIn pigs with acute graft rejection, the AUC decreased significantly after transplantation as compared with that of non-rejection transplant group (F=11.069, P=0.011), but the parameters including A, Alpha, C, t(0), DPI, or TTP showed no significant differences between the two groups.

CONCLUSIONSPulse-inversion contrast harmonic imaging combined with acoustic quantitative technology can be an efficient means for evaluating blood perfusion in the liver allograft, and the TIC obtained using this method possesses high values for quantitative evaluation of liver allograft rejection.

Animals ; Contrast Media ; Female ; Fluorocarbons ; Graft Rejection ; diagnostic imaging ; Image Enhancement ; Liver ; blood supply ; Liver Transplantation ; adverse effects ; Male ; Perfusion ; Random Allocation ; Swine ; Swine, Miniature ; Transplantation, Homologous ; Ultrasonography, Doppler, Color ; methods

OBJECTIVE: To evaluate the role of contrast enhanced power Doppler in evaluating tumor angiogenetic activity. METHODS: Thirty-two patients with hepatocellular carcinoma were analysed. Flow signals of hepatocellular carcinoma were observed by power Doppler imaging after the injection of contrast agent, and then the relative perfusion rate and blood flow were assessed. The microvessel density (MVD) and vascular endothelial growth factor(VEGF) were assessed by immunohistochemical method. The relationship between the relative perfusion rate,blood flow, MVD,VEGF was studied. RESULTS: The relative perfusion rate in the tissues with positive expression of VEGF was significantly higher than that in the tissues with negative expression of VEGF in hepatocellular carcinoma. There was correlation between the relative perfusion rate, blood flow grade and MVD(P<0.05). The expression of VEGF was positively related to the relative perfusion rate and blood flow grade(P<0.05). CONCLUSION Contrast enhanced power Doppler is useful in evaluating the tumor angiogenetic activity.
Aged ; Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Contrast Media ; Female ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Male ; Middle Aged ; Neovascularization, Pathologic ; Ultrasonography, Doppler ; methods

OBJECTIVE: To analyze the contrast-enhancement patterns obtained at pulseinversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect. MATERIALS AND METHODS: We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns. RESULTS: Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively. CONCLUSION: Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.
Adult ; Aged ; Carcinoma, Hepatocellular/blood supply/*ultrasonography ; Colon/pathology ; Contrast Media/*administration & dosage ; Diagnosis, Differential ; Female ; Hemangioma/blood supply/*ultrasonography ; Human ; Image Enhancement/*methods ; Liver/pathology/ultrasonography ; Liver Neoplasms/blood supply/secondary/*ultrasonography ; Lung/pathology ; Male ; *Microbubbles ; Middle Aged ; Pancreas/pathology ; Polysaccharides/administration & dosage/diagnostic use ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Stomach/pathology ; Support, Non-U.S. Gov't

No abstract available.
Animals ; Chronic Disease ; Endothelium, Vascular/*ultrasonography ; Human ; Liver/*blood supply ; Liver Diseases/*pathology ; Microcirculation/ultrasonography ; Rats

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hematologic Tests ; Humans ; Liver Cirrhosis ; pathology ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; pathology ; Severity of Illness Index ; Spleen ; blood supply ; pathology ; Splenic Vein ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color