Quantitative assessment of hepatic fibrosis by contrast-enhanced ultrasonography.

OBJECTIVE: To explore the contrast-enhanced ultrasonographic features for quantitative assessment of hepatic fibrosis.

METHODS: 86 patients with chronic viral hepatitis B were enrolled in this study from March 2007 to August 2009. The patients were classified into 5 groups (S(0)-S(4)) according to fibrosis stage evaluated with ultrasound guided liver biopsy. New contrast-enhanced ultrasonography (CEUS) features including area under the time-intensity curve (TIC) of portal venous phase/hepatic arterial phase (Qp/Qa) and intensity of portal venous phase/hepatic arterial phase (Ip/Ia) were used to detect the blood supply ratio (portal vein/hepatic artery) in each group. Arrival time of portal vein trunk (Tp) and decreasing rate of TIC (β) were also analyzed.

RESULTS: Qp/Qa and Ip/Ia decreased from S(0) to S(4), while Tp and β increased. These 4 features were significantly correlated with the degree of fibrosis (P<0.001) and were significantly different among the five groups (P<0.001). Sensitivity and specificity of Ip/Ia were 80% and 86% for groups ≥S(1), 75% and 86% for groups ≥ S(2), 71% and 84% for groups ≥ S(3), and 76% and 80% for group S(4), respectively. Sensitivity and specificity of Qp/Qa were 70% and 88% for groups ≥ S(1), 80% and 76% for groups ≥ S(2), 74% and 70% for groups ≥ S(3), and 81% and 95% for group S(4), respectively.

CONCLUSION: Ip/Ia and Qp/Qa could be adopted as reliable, non-invasive features for quantitative assessment of hepatic fibrosis.