Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.486
Peer-review started: August 29, 2016
First decision: September 28, 2016
Revised: October 7, 2016
Accepted: October 30, 2016
Article in press: October 31, 2016
Published online: January 21, 2017
To evaluated vascular dynamic processes in the liver of hereditary hemorrhagic telangiectasia (HHT) patients by ultrasound (US) considering quantitative analytic methods.
The imaging features on US and contrast-enhanced ultrasound (CEUS) in 18 patients diagnosed with HHT were retrospectively analyzed. Regarding CEUS, real-time contrast harmonic imaging and sulfur hexafluoride-filled microbubbles were used.
HVaMs were identified in all 18 patients. By US, the two major Caselitz criteria could be detected in 55.6% patients. "Color spots" were detected in 72.2% of the cases. Respecting sonographic grading criteria by Buscarini, grade 3 could be demonstrated most frequent (40%). By CEUS, all the patients showed quick and early hyperenhancement during the arterial phase. Significant lowest time to peak (TTP) and highest area under the curve (AUC) values were identified in the hepatic artery (TTP: 69.8%; AUC: 100%) and highest TTP and lowest AUC in the hepatic parenchyma and the portal vein.
For the first time we analyzed CEUS findings of a group of HHT patients regarding macro- and microcirculation. Our data demonstrate significant differences in TTP and AUC values in the four selected regions: hepatic artery, shunt region, portal vein and hepatic parenchyma.
Core tip: For the first time we analyzed contrast-enhanced ultrasound (CEUS) examination of a group of 18 hereditary hemorrhagic telangiectasia (HHT) patients regrading macro- and microcirculation. This new information could be used to sub-classify a high risk group of asymptomatic patients with therapeutic indication. With regard to the advent of new therapeutic agents, CEUS analysis can complete the required accurate cost-effective screening methods in HHT patients.