Non-Invasive Diagnosis of Portal Hypertensive Gastropathy: Quantitative Analysis of Microbubble-Induced Stomach Wall Enhancement

Ultrasound Med Biol. 2016 Aug;42(8):1792-9. doi: 10.1016/j.ultrasmedbio.2016.03.011. Epub 2016 May 7.

Abstract

The aim of the study described here was to elucidate the efficacy of contrast-enhanced ultrasound (CEUS) prospectively as a tool in the diagnosis of portal hypertensive gastropathy (PHG). The peak enhancement time at the upper stomach wall (PT) and intensity ratio at the upper stomach/the spleen (IR) between pre- and peak enhancement were evaluated by CEUS with perflubutane microbubble agent in 56 patients, 42 with cirrhosis (16 with PHG) and 14 controls. The IR was higher in patients with PHG (1.21 ± 0.11) than in those without (0.91 ± 0.15, p < 0.05) and the controls (0.78 ± 0.11, p < 0.01), although PT did not differ between these groups. The area under the receiver operating characteristic curve for IR was 0.8199 in the presence of PHG, with the best cutoff value of 0.94, sensitivity 65.9%, specificity 72.6%, positive predictive value 62.2%, negative predictive value 73.1% and accuracy 70.4%. CEUS may have potential as a less invasive tool for diagnosis of PHG in patients with cirrhosis.

Keywords: Cirrhosis; Contrast-enhanced ultrasound; Portal hypertensive gastropathy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Hypertension, Portal / complications*
  • Hypertension, Portal / diagnostic imaging*
  • Hypertension, Portal / physiopathology
  • Image Enhancement / methods*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / physiopathology
  • Male
  • Microbubbles*
  • Middle Aged
  • Portal Vein / diagnostic imaging
  • Portal Vein / physiopathology
  • Sensitivity and Specificity
  • Stomach / diagnostic imaging

Substances

  • Contrast Media