Impact of Contrast-Enhanced Ultrasound on Hepatic Two-Dimensional Shear Wave Elastography: Does Elastography Need to be Performed Before Contrast Administration?

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2025-06-27 DOI:10.1016/j.ultrasmedbio.2025.05.029

Jiayao Huang, Qingyu Wu, Bowen Zhuang, Baoxian Liu, Lu Yao, Haiyi Long, Xian Zhong, Xiaoyan Xie, Liya Su, Manxia Lin

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引用次数: 0

Abstract

Objective: The present study aims to explore the dynamic impact of contrast-enhanced ultrasound (CEUS) on hepatic two-dimensional shear wave elastography (2D-SWE), especially in its assessment of liver fibrosis, and to analyze the pathological and biological basis of this impact.

Methods: From August 2023 to August 2024, 220 participants were prospectively enrolled, among which 111 underwent liver histopathological examination. The 2D-SWE examinations were conducted at the pre-CEUS phase, CEUS phase (5-6 min after the injection of SonoVue), early post-CEUS phase (8-10 min after the injection), and late post-CEUS phase (25-30 min after the injection), respectively. Analysis of variance compared the indexes across different phases. Multivariate linear regression analyses identified the factors influencing the difference in 2D-SWE measurement values (Emean) between pre-CEUS and CEUS phases.

Results: Emean at the CEUS phase and early post-CEUS phase was significantly lower than the pre-CEUS levels [the mean difference was 1.70 kPa and 0.90 kPa, respectively, both p < 0.001]. At the late post-CEUS phase, the Emean returned to the pre-CEUS levels (p = 0.078). Compared to the pre-CEUS phase, the percentage of the downgrade of significant fibrosis at the CEUS, early post-CEUS, and late post-CEUS phase was 55.3%, 35.3%, and 6.0%, respectively; while the downgrade of cirrhosis was 37.8%, 18.3%, and 2.4%, respectively. Liver inflammatory activity (p = 0.008, β = 0.88, 95% CI = 0.24-1.52) independently influenced the differences between the pre-CEUS and CEUS phase Emean. The higher the inflammatory activity grade, the greater the differences in Emean.

Conclusion: Following CEUS, 2D-SWE measurement values initially decrease and subsequently return to baseline levels. This transient decrease can lead to a downgraded assessment of liver fibrosis. Furthermore, the liver inflammatory activity is an independent factor influencing the magnitude of the reduction in 2D-SWE measurement values after CEUS.

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造影剂增强超声对肝脏二维横波弹性成像的影响：在造影剂给药前需要进行弹性成像吗？

目的：本研究旨在探讨超声造影（CEUS）对肝脏二维剪切波弹性成像（2D-SWE）的动态影响，特别是对肝纤维化的评估，并分析这种影响的病理生物学基础。方法：于2023年8月至2024年8月，前瞻性纳入220例受试者，其中111例进行肝脏组织病理学检查。分别在超声造影前、超声造影期（注射SonoVue后5-6分钟）、超声造影后早期（注射后8-10分钟）和超声造影后晚期（注射后25-30分钟）进行2D-SWE检查。方差分析对各阶段指标进行比较。多元线性回归分析确定了影响超声造影前与超声造影期2D-SWE测量值（Emean）差异的因素。结果：超声造影期及超声造影后早期Emean明显低于超声造影前水平[平均差值分别为1.70 kPa和0.90 kPa, p < 0.001]。在超声造影后晚期，Emean恢复到超声造影前的水平（p = 0.078）。与前CEUS期相比，CEUS期、CEUS后早期和CEUS后晚期显著纤维化降级的比例分别为55.3%、35.3%和6.0%；肝硬化降级率分别为37.8%、18.3%和2.4%。肝脏炎症活动（p = 0.008, β = 0.88, 95% CI = 0.24-1.52）独立影响超声造影前和超声造影期Emean的差异。炎症活动等级越高，eman差异越大。结论：超声造影后，2D-SWE测量值开始下降，随后恢复到基线水平。这种短暂的降低可导致对肝纤维化的评估降低。此外，肝脏炎症活性是影响超声造影后2D-SWE测量值降低幅度的独立因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.