CEUS and Fibroscan in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Figure 1 Example in a healthy control of the split-screen display during the contrast-enhanced ultrasound procedure upon the injection of SonoVue^® using a low mechanical index. Left: B-mode frame; Right: Contrast-enhanced ultrasound frame. PV: Portal vein; LP: Liver parenchyma. The B-mode frame shows more detail because of the higher gain.

Figure 2 Example of region of interest selection in the portal vein and Qontrast^®-assisted contrast-enhanced ultrasound analysis of portal vein parameters in healthy control. A: Region of interest (ROI) drawn in a region of the portal vein (PV) in a selected set of higher signal intensity frames 1 min and 10 s after SonoVue^® injection; B: A gamma variate (bolus)-corrected parametric curve for the translational movement caused by breathing activity. SI (%): Signal intensity; PEAK (%): Maximum signal intensity reached during SonoVue^® bolus injection; TTP (s): Time to peak; RBV (cm³): Regional blood volume; RBF (cm³/s): Regional blood flow; MTT (s): Mean transit time.

Figure 3 Contrast-enhanced ultrasound of the portal vein in controls, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. A: Peak (%); B: TTP (s); C: RBV (cm³); D: RBF (cm³/s); Peak (%): Maximum signal intensity (SI) reached during SonoVue^® bolus injection; TTP (s): Time to peak; RBV (cm³): Regional blood volume; RBF (cm³/s): Regional blood flow; NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.

Figure 4 Contrast-enhanced ultrasound of liver parenchyma in controls, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. A: Peak (%); B: TTP (s); C: RBV (cm³); D: RBF (cm³/s); Peak (%): Maximum signal intensity (SI) reached during SonoVue^® bolus injection; TTP (s): Time to peak; RBV (cm³): Regional blood volume; RBF (cm³/s): Regional blood flow; NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.

Figure 5 Contrast-enhanced ultrasound of the portal vein (A) and liver parenchyma (B) in controls, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: Mean transit time (s). NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.

Figure 6 Fibroscan in controls, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.