The New Applications of Contrast Enhanced Ultrasound for Hepatic Fibrosis and Portal Hypertension

Seul Ki, Han; Soon Koo, Baik; Kim, Moon Young; Seul Ki, Han; Soon Koo, Baik; Kim, Moon Young

Clin Ultrasound > Accepted Articles

Han Seul Ki¹

, Baik Soon Koo¹

, Moon Young Kim¹

¹Department of Internal Medicine, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
²Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea
³Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea

Address for Correspondence:

Moon Young Kim ,Tel: 82-33-7411229, Fax: 82-10-741-0951, Email: drkimmy@yonsei.ac.kr

Received: 3 October 2023; Accepted: 23 October 2023. Published online: 23 October 2023.

ABSTRACT

There are unmet needs in primary care centers with respect to patients with cirrhosis. Liver biopsy and measurement of hepatic venous pressure gradient in patients with cirrhosis are the gold standards for the estimation of hepatic fibrosis, and they have diagnostic and prognostic value. However, both approaches are invasive and cannot be used repeatedly in clinical practice. Ultrasonography (US) is safe, easy to perform, inexpensive, and yields numerical and accurate results. Contrast-enhanced US (CEUS) using second generation microbubble ultrasonography agents (USA) is able to show the vascular structure and enhancement pattern of lesions, so it has a worth in the diagnosis of hepatocellular carcinoma (HCC) which is a typical cancer that has a characteristic neovascularization. Beyond the diagnosis of HCC, recently, functional US indices based on CEUS have been suggested as promising markers for diagnosing fibrosis and portal hypertension (PH). Although investigations of the reproducibility and long-term prognostic value through further studies, CEUS based indices are expected as promising quantitative non-invasive tests to estimate the severity of hepatic fibrosis and PH. Therefore in this paper, we will describe about the characteristics of 2nd generation microbubble USA and the usefulness of CEUS based indices for hepatic fibrosis and PH.

Keywords: Contrast enhanced ultrasound; Portal hypertension; Hepatic fibrosis; Cirrhosis