Measuring intrahepatic vascular changes using contrast-enhanced ultrasonography to predict the prognosis of alcoholic hepatitis combined with cirrhosis: A prospective pilot study

Min Sun Park, Soonchang Hong, Yoo Li Lim, Seong Hee Kang, Soon Koo Baik, Moon Young Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/Aims: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. Methods: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue®). The primary outcome was 12-week mortality. Results: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95% confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5% survival rate even if the MDF score ≥32; however, HVAT <11.0 seconds was related with mortality despite a MDF score<32. Conclusions: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.

Original languageEnglish
Pages (from-to)555-561
Number of pages7
JournalGut and liver
Volume12
Issue number5
DOIs
Publication statusPublished - 2018 Sep

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Alcoholic Hepatitis
Hepatic Veins
Blood Vessels
Ultrasonography
Fibrosis
Prospective Studies
Mortality
Alcoholic Liver Cirrhosis
Microbubbles
Time and Motion Studies
Liver
Ultrasonics
ROC Curve
Survival Rate
Perfusion
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{f6ca07bc560746b09fa27cdb0eee5b88,
title = "Measuring intrahepatic vascular changes using contrast-enhanced ultrasonography to predict the prognosis of alcoholic hepatitis combined with cirrhosis: A prospective pilot study",
abstract = "Background/Aims: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. Methods: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue{\circledR}). The primary outcome was 12-week mortality. Results: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95{\%} confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5{\%} survival rate even if the MDF score ≥32; however, HVAT <11.0 seconds was related with mortality despite a MDF score<32. Conclusions: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.",
author = "Park, {Min Sun} and Soonchang Hong and Lim, {Yoo Li} and Kang, {Seong Hee} and Baik, {Soon Koo} and Kim, {Moon Young}",
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Measuring intrahepatic vascular changes using contrast-enhanced ultrasonography to predict the prognosis of alcoholic hepatitis combined with cirrhosis : A prospective pilot study. / Park, Min Sun; Hong, Soonchang; Lim, Yoo Li; Kang, Seong Hee; Baik, Soon Koo; Kim, Moon Young.

In: Gut and liver, Vol. 12, No. 5, 09.2018, p. 555-561.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Measuring intrahepatic vascular changes using contrast-enhanced ultrasonography to predict the prognosis of alcoholic hepatitis combined with cirrhosis

T2 - A prospective pilot study

AU - Park, Min Sun

AU - Hong, Soonchang

AU - Lim, Yoo Li

AU - Kang, Seong Hee

AU - Baik, Soon Koo

AU - Kim, Moon Young

PY - 2018/9

Y1 - 2018/9

N2 - Background/Aims: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. Methods: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue®). The primary outcome was 12-week mortality. Results: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95% confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5% survival rate even if the MDF score ≥32; however, HVAT <11.0 seconds was related with mortality despite a MDF score<32. Conclusions: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.

AB - Background/Aims: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. Methods: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue®). The primary outcome was 12-week mortality. Results: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95% confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5% survival rate even if the MDF score ≥32; however, HVAT <11.0 seconds was related with mortality despite a MDF score<32. Conclusions: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.

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DO - 10.5009/gnl17342

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JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

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