Intrahepatic circulatory time analysis of an ultrasound contrast agent in liver cirrhosis

Objective: To assess the diagnostic accuracy and advantages of intrahepatic circulatory time analysis of an ultrasound contrast agent using pulse-inversion imaging as compared with recently reported noninvasive diagnostic tests for cirrhosis. Methods: Forty patients divided into noncirrhotic (nonLC) (n=20) and compensated cirrhotic (LC) (n=20) groups were studied prospectively. After intravenous administration of a contrast agent, the arrival times at the hepatic artery (HA), portal vein (PV), and hepatic vein (HV) were measured by pulse-inversion imaging. Intrahepatic circulatory time was calculated as the difference between the HV and HA arrival times (HV-HA interval time) or the HV and PV arrival times (HV-PV interval time). Results: The HV-HA and HV-PV interval times were significantly shorter in the LC group (7.4 +/- 1.7 and 1.9 +/- 1.5 s, respectively) compared with those in the nonLC group (normal: 15.6 +/- 2.1 and 11.1 +/- 1.7 s, respectively; P < 0.001 and P < 0.001, respectively, and hepatitis: 12.8 +/- 4.1 and 7.8 +/- 4.4 s, respectively; P < 0.001 and P < 0.002, respectively). Each intrahepatic circulatory time showed the highest accuracy rate for cirrhosis in other noninvasive diagnostic tests. Conclusions: This analysis, which is considered to reflect intrahepatic hemodynamic changes, is a useful noninvasive diagnostic test for compensated cirrhosis.