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 ± 12.6 years, 30-86; 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 ± 1.8; 14.6 ± 3.0) and controls (4.0 ± 1.9, p < 0.0001; 8.9 ± 2.3, p < 0.0001), respectively. However, only PET offered positive correlations with wedged hepatic venous pressure (r = 0.4648, p = 0.0001) and HVPG (r = 0.4573, p = 0.0001). The area under the receiver operating characteristics curve to identify HVPG ≥ 10 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 hypertension presumably by reflecting congestion of splenic venous flow due to increased portal venous pressure.
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 ± 12.6 years, 30-86; 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 ± 1.8; 14.6 ± 3.0) and controls (4.0 ± 1.9, p < 0.0001; 8.9 ± 2.3, p < 0.0001), respectively. However, only PET offered positive correlations with wedged hepatic venous pressure (r = 0.4648, p = 0.0001) and HVPG (r = 0.4573, p = 0.0001). The area under the receiver operating characteristics curve to identify HVPG ≥ 10 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 hypertension presumably by reflecting congestion of splenic venous flow due to increased portal venous pressure.
Authors: J Vorobioff; R J Groszmann; E Picabea; M Gamen; R Villavicencio; J Bordato; I Morel; M Audano; H Tanno; E Lerner; M Passamonti Journal: Gastroenterology Date: 1996-09 Impact factor: 22.682
Authors: Enrique de-Madaria; José María Palazón; Flavia Tamara Hernández; José Sánchez-Paya; Pedro Zapater; Javier Irurzun; Francisco de España; Sonia Pascual; José Such; Laura Sempere; Fernando Carnicer; Antonio García-Herola; Jaime Valverde; Miguel Pérez-Mateo Journal: Eur J Gastroenterol Hepatol Date: 2010-05 Impact factor: 2.566
Authors: Alberto Monescillo; Francisco Martínez-Lagares; Luis Ruiz-del-Arbol; Angel Sierra; Clemencia Guevara; Elena Jiménez; José Miguel Marrero; Enrique Buceta; Juan Sánchez; Ana Castellot; Mónica Peñate; Ana Cruz; Elena Peña Journal: Hepatology Date: 2004-10 Impact factor: 17.425
Authors: M Bolognesi; D Sacerdoti; C Merkel; G Gerunda; A Maffei-Faccioli; P Angeli; R M Jemmolo; G Bombonato; A Gatta Journal: Hepatology Date: 1996-05 Impact factor: 17.425
Authors: Juan Turnes; Juan Carlos Garcia-Pagan; Juan G Abraldes; Manuel Hernandez-Guerra; Alessandra Dell'Era; Jaime Bosch Journal: Am J Gastroenterol Date: 2006-03 Impact factor: 10.864
Authors: Jayant A Talwalkar; Meng Yin; Sudhakar Venkatesh; Phillip J Rossman; Roger C Grimm; Armando Manduca; Anthony Romano; Patrick S Kamath; Richard L Ehman Journal: AJR Am J Roentgenol Date: 2009-07 Impact factor: 3.959