脑死亡供体肝脏超声造影定量分析：预测早期同种异体移植功能障碍。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2025-02-20 DOI:10.1016/j.ultrasmedbio.2024.11.018

Jiao Sun , Xiuyun Ren , Di Zhang , Zizhen Yang , Xiaodong Wu , Chuanshen Xu , Jinzhen Cai , Jianhong Wang

{"title":"脑死亡供体肝脏超声造影定量分析：预测早期同种异体移植功能障碍。","authors":"Jiao Sun , Xiuyun Ren , Di Zhang , Zizhen Yang , Xiaodong Wu , Chuanshen Xu , Jinzhen Cai , Jianhong Wang","doi":"10.1016/j.ultrasmedbio.2024.11.018","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To determine the CEUS parameters that predict the likelihood of postoperative EAD.</div></div><div><h3>Methods</h3><div>Clinical and imaging data for 75 pairs of donors and recipients collected between September 2022 and July 2023 were retrospectively analyzed. Subjects were divided into those with early allograft dysfunction (EAD) and those without EAD. The liver parenchyma was selected as the region of interest to plot the CEUS time–intensity curve. CEUS parameters were compared between the two groups.</div></div><div><h3>Results</h3><div>Peak intensity, area under the curve (AUC), and cholinesterase values were significantly lower in the EAD group than in the non-EAD group. The hepatic arterial–portal arrival interval (APAI) and aspartate aminotransferase level were significantly higher in the EAD group. Multivariate logistic analysis identified the APAI to be an independent risk factor for EAD (odds ratio 0.755; 95% confidence interval 0.577–0.989; <em>p</em> = 0.041). Receiver-operating characteristic curve analysis showed that the prediction probability P, which represents a combination of CEUS and clinical data, was best able to predict EAD (AUC 0.802; 95% confidence interval 0.679–0.926; <em>p</em> < 0.0001). Comparison of the AUC for prediction probability P and each single parameter identified statistically significant differences between the predicted probability P and aspartate aminotransferase and cholinesterase values (<em>p</em> = 0.042 and <em>p</em> = 0.020, respectively).</div></div><div><h3>Conclusion</h3><div>A longer APAI can be used as a biomarker to predict EAD after brain-dead donor liver transplantation. CEUS could be a valuable tool for assessment of donor livers and identifying recipients potentially at risk of developing postoperative EAD.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 5","pages":"Pages 735-741"},"PeriodicalIF":2.4000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quantitative Analysis of Contrast-Enhanced Ultrasound Images of Brain-Dead Donor Livers: Prediction of Early Allograft Dysfunction\",\"authors\":\"Jiao Sun , Xiuyun Ren , Di Zhang , Zizhen Yang , Xiaodong Wu , Chuanshen Xu , Jinzhen Cai , Jianhong Wang\",\"doi\":\"10.1016/j.ultrasmedbio.2024.11.018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To determine the CEUS parameters that predict the likelihood of postoperative EAD.</div></div><div><h3>Methods</h3><div>Clinical and imaging data for 75 pairs of donors and recipients collected between September 2022 and July 2023 were retrospectively analyzed. Subjects were divided into those with early allograft dysfunction (EAD) and those without EAD. The liver parenchyma was selected as the region of interest to plot the CEUS time–intensity curve. CEUS parameters were compared between the two groups.</div></div><div><h3>Results</h3><div>Peak intensity, area under the curve (AUC), and cholinesterase values were significantly lower in the EAD group than in the non-EAD group. The hepatic arterial–portal arrival interval (APAI) and aspartate aminotransferase level were significantly higher in the EAD group. Multivariate logistic analysis identified the APAI to be an independent risk factor for EAD (odds ratio 0.755; 95% confidence interval 0.577–0.989; <em>p</em> = 0.041). Receiver-operating characteristic curve analysis showed that the prediction probability P, which represents a combination of CEUS and clinical data, was best able to predict EAD (AUC 0.802; 95% confidence interval 0.679–0.926; <em>p</em> < 0.0001). Comparison of the AUC for prediction probability P and each single parameter identified statistically significant differences between the predicted probability P and aspartate aminotransferase and cholinesterase values (<em>p</em> = 0.042 and <em>p</em> = 0.020, respectively).</div></div><div><h3>Conclusion</h3><div>A longer APAI can be used as a biomarker to predict EAD after brain-dead donor liver transplantation. CEUS could be a valuable tool for assessment of donor livers and identifying recipients potentially at risk of developing postoperative EAD.</div></div>\",\"PeriodicalId\":49399,\"journal\":{\"name\":\"Ultrasound in Medicine and Biology\",\"volume\":\"51 5\",\"pages\":\"Pages 735-741\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ultrasound in Medicine and Biology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0301562924004423\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound in Medicine and Biology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0301562924004423","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ACOUSTICS","Score":null,"Total":0}

引用次数: 0

摘要

目的：确定预测术后EAD发生可能性的超声造影参数。方法：回顾性分析2022年9月至2023年7月收集的75对供体和受者的临床和影像学资料。受试者分为早期同种异体移植物功能障碍（EAD）组和无EAD组。选择肝实质为感兴趣区域绘制超声造影时间强度曲线。比较两组超声造影参数。结果：EAD组的峰值强度、曲线下面积（AUC）、胆碱酯酶值均明显低于非EAD组。EAD组肝动脉-门脉到达间隔（APAI）和天冬氨酸转氨酶水平显著升高。多因素logistic分析发现APAI是EAD的独立危险因素(优势比0.755；95%置信区间0.577-0.989；P = 0.041)。受试者工作特征曲线分析显示，超声造影与临床资料相结合的预测概率P最能预测EAD (AUC 0.802；95%置信区间0.679-0.926；P < 0.0001)。比较预测概率P与各单项参数的AUC，发现预测概率P与天冬氨酸转氨酶、胆碱酯酶值差异有统计学意义（P = 0.042、P = 0.020）。结论：较长的APAI可作为预测脑死亡供肝移植术后EAD的生物标志物。超声造影可作为评估供体肝脏和确定受者术后发生EAD的潜在风险的一种有价值的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Quantitative Analysis of Contrast-Enhanced Ultrasound Images of Brain-Dead Donor Livers: Prediction of Early Allograft Dysfunction

Objective

To determine the CEUS parameters that predict the likelihood of postoperative EAD.

Methods

Clinical and imaging data for 75 pairs of donors and recipients collected between September 2022 and July 2023 were retrospectively analyzed. Subjects were divided into those with early allograft dysfunction (EAD) and those without EAD. The liver parenchyma was selected as the region of interest to plot the CEUS time–intensity curve. CEUS parameters were compared between the two groups.

Results

Peak intensity, area under the curve (AUC), and cholinesterase values were significantly lower in the EAD group than in the non-EAD group. The hepatic arterial–portal arrival interval (APAI) and aspartate aminotransferase level were significantly higher in the EAD group. Multivariate logistic analysis identified the APAI to be an independent risk factor for EAD (odds ratio 0.755; 95% confidence interval 0.577–0.989; p = 0.041). Receiver-operating characteristic curve analysis showed that the prediction probability P, which represents a combination of CEUS and clinical data, was best able to predict EAD (AUC 0.802; 95% confidence interval 0.679–0.926; p < 0.0001). Comparison of the AUC for prediction probability P and each single parameter identified statistically significant differences between the predicted probability P and aspartate aminotransferase and cholinesterase values (p = 0.042 and p = 0.020, respectively).

Conclusion

A longer APAI can be used as a biomarker to predict EAD after brain-dead donor liver transplantation. CEUS could be a valuable tool for assessment of donor livers and identifying recipients potentially at risk of developing postoperative EAD.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

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.