Effectiveness of contrast-enhanced ultrasound and serum liver enzyme measurement in detection and classification of blunt liver trauma

J Int Med Res. 2017 Feb;45(1):170-181. doi: 10.1177/0300060516678525. Epub 2017 Jan 11.

Abstract

Objective This study was performed to identify the correlation between contrast-enhanced ultrasound (CEUS) and contrast-enhanced multidetector computed tomography (CE-MDCT) as well as the correlation between serum liver enzyme concentrations and CE-MDCT in classification of the severity of blunt hepatic trauma using CE-MDCT as a reference standard. Materials and methods A blunt liver trauma model was created using 20 rabbits, and CE-MDCT, CEUS, and serum liver enzyme assays were performed. A radiologist and an ultrasound physician independently evaluated the degree of liver trauma. The diagnostic performance of CEUS and serum liver enzyme measurements was compared with that of CE-MDCT using Spearman's correlation analysis and Pearson's correlation analysis, respectively. Results Spearman's rank correlation coefficient between the CEUS-based classification and CE-MDCT was 0.888. The aspartate aminotransferase and lactate dehydrogenase concentrations and the aspartate aminotransferase/alanine aminotransferase ratio were positively correlated with the grade of liver injury; Pearson's correlation coefficients were 0.664, 0.704, and 0.503, respectively. The gamma-glutamyltransferase concentration had a significantly negative correlation with the grade of liver injury (r = -0.467). Conclusions CEUS and serum liver enzyme measurement exhibited high consistency with CE-MDCT for both detection and grading of intraparenchymal lesions in blunt liver trauma. These techniques may permit more accurate diagnosis of liver trauma.

Keywords: Contrast-enhanced ultrasound; contrast-enhanced multidetector computed tomography; liver enzyme; liver trauma.

MeSH terms

  • Alanine Transaminase / blood
  • Animals
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood
  • Contrast Media / administration & dosage
  • Disease Models, Animal
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Liver / diagnostic imaging*
  • Liver / enzymology*
  • Liver / injuries
  • Liver / pathology
  • Male
  • Multidetector Computed Tomography
  • Rabbits
  • Trauma Severity Indices
  • Ultrasonography / methods
  • Wounds, Nonpenetrating / blood*
  • Wounds, Nonpenetrating / diagnostic imaging*
  • Wounds, Nonpenetrating / pathology
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • Contrast Media
  • L-Lactate Dehydrogenase
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase