Noritaka Wakui1,2, Yuki Takeda3, Shuta Nishinakagawa3, Nobuo Ueki3, Takafumi Otsuka3,4, Nobuyuki Oba3, Hiroshi Hashimoto5, Naohisa Kamiyama5, Yasukiyo Sumino4, Tatsuya Kojima3. 1. Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo, Japan. toho_med_wakui@yahoo.co.jp. 2. Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota, Tokyo, 143-8541, Japan. toho_med_wakui@yahoo.co.jp. 3. Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo, Japan. 4. Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota, Tokyo, 143-8541, Japan. 5. Ultrasound General Imaging, GE Healthcare, Tokyo, Japan.
Abstract
PURPOSE: To prospectively clarify the effects of obstructive jaundice (OJ) on hepatic hemodynamics using contrast-enhanced ultrasonography (US). METHODS: Subjects comprised 14 patients admitted to our hospital for OJ between April 2013 and March 2014. Contrast-enhanced US was performed using the LOGIQ E9 ultrasound device during the jaundice phase, before biliary drainage, and again after improvement of jaundice. After injecting the Sonazoid contrast agent, contrast dynamics were recorded in the right kidney and liver segments 5 or 6. Prototype software was used to calculate mean arrival time (AT) of the contrast agent in the liver parenchyma. Statistical analysis was performed to compare the mean AT in the jaundice and improved jaundice phases. RESULTS: We were unable to follow up three of the 14 patients after biliary drainage; thus, we included 11 patients for further analysis. The mean AT of the contrast agent was 2.0 ± 1.8 and 6.1 ± 2.3 s in the jaundice and improved jaundice phases, respectively, showing significantly shorter AT in the jaundice phase (p = 0.0033). CONCLUSION: Our findings indicate that OJ may influence the blood flow balance between the hepatic portal vein and hepatic artery.
PURPOSE: To prospectively clarify the effects of obstructive jaundice (OJ) on hepatic hemodynamics using contrast-enhanced ultrasonography (US). METHODS: Subjects comprised 14 patients admitted to our hospital for OJ between April 2013 and March 2014. Contrast-enhanced US was performed using the LOGIQ E9 ultrasound device during the jaundice phase, before biliary drainage, and again after improvement of jaundice. After injecting the Sonazoid contrast agent, contrast dynamics were recorded in the right kidney and liver segments 5 or 6. Prototype software was used to calculate mean arrival time (AT) of the contrast agent in the liver parenchyma. Statistical analysis was performed to compare the mean AT in the jaundice and improved jaundice phases. RESULTS: We were unable to follow up three of the 14 patients after biliary drainage; thus, we included 11 patients for further analysis. The mean AT of the contrast agent was 2.0 ± 1.8 and 6.1 ± 2.3 s in the jaundice and improved jaundice phases, respectively, showing significantly shorter AT in the jaundice phase (p = 0.0033). CONCLUSION: Our findings indicate that OJ may influence the blood flow balance between the hepatic portal vein and hepatic artery.
Entities:
Keywords:
Arrival time parametric imaging; Contrast-enhanced ultrasonography; Obstructive jaundice; Sonazoid
Authors: M Miyazaki; H Ito; K Nakagawa; S Ambiru; H Shimizu; T Okaya; K Shinmura; N Nakajima Journal: J Am Coll Surg Date: 1999-12 Impact factor: 6.113