Diagnostic Utility of Superb Microvascular Imaging of ultrasound Examinations to Evaluate Hepatic Ischemia-reperfusion Injury

doi:10.37015/AUDT.2024.230010

Abstract

Abstract:

Objective To investigate the effectiveness of SMI in evaluating hepatic IRI and detecting its therapy response.

Methods Thirty rats were randomly divided into sham (n = 12), IRI (n = 12), and andrographolide pretreatment (n = 6) groups. SMI, pathological, and biochemical examinations were conducted for the sham and IRI groups at 4 (n = 6) and 24 h (n = 6) after reperfusion, respectively. Two ultrasonologists measured the vascular index (VI). The interobserver agreement was evaluated using the intraclass correlation coefficient (ICC). The rat liver parameters, including Suzuki's score, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were obtained at different time steps in each group. For the andrographolide pretreatment group, data were obtained at 24 h after reperfusion to further verify the advantage of VI. Parameters were analyzed for correlations and compared between each group at 4 and 24 h.

Results The ICC between two ultrasonologists who measured the VI was 0.912 (95%CI: 0.889-0.940). Suzuki's score and VI were negatively correlated (r = -0.504, P = 0.012). Compared with the sham group, the IRI group showed a significant decrease in the VI at 4 and 24 h after reperfusion [(24.78 ± 3.23) versus (20.22 ± 2.55); (22.67 ± 1.36) versus (19.27 ± 2.23), P < 0.05)]. The VI in the andrographolide pretreatment group was higher than that in the IRI group [(21.90 ± 1.47) versus (19.27 ± 2.23), P <0.05].

Conclusions The VI on SMI can be used as a noninvasive and sensitive index to evaluate hepatic IRI and detect its therapeutic response.

Key words: Ultrasonography; Superb microvascular imaging (SMI); Vascular Index (VI); Hepatic ischemia-reperfusion injury (IRI); Microcirculatory disruption

Guoying Zhang, MD, Ying Tang, BS, Mingyang Wang, MD, Weina Kong, MD. Diagnostic Utility of Superb Microvascular Imaging of ultrasound Examinations to Evaluate Hepatic Ischemia-reperfusion Injury. Advanced Ultrasound in Diagnosis and Therapy, 2024, 8(1): 15-21.

Figures/Tables 6

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Score	Sinusoidal congestion (%)	Vacuolization/ballooning (%)	Necrosis (%)
0	None	None	None
1	Minimal (< 10%)	Minimal (< 10%)	Single cell
2	Mild (11%-30%)	Mild (11%-30%)	Mild (11%-30%)
3	Moderate (30%-60%)	Moderate (30%-60%)	Moderate (30%-60%)
4	Severe (> 60%)	Severe (> 60%)	Severe (> 60%)

Item	4h		24h
Item	Sham group	IRI group	Sham group	IRI group	Treatment group
VI (%)	24.78±3.22	20.22±2.54^*	22.67±1.36	19.27±2.23^*	21.90±1.47^‡
95%CI of VI	21.4-28.2	17.5-22.8	21.2-24.0	16.9-21.6	20.3-23.4
AST(U/L)	344.2 (230.9, 377.3)	497.0 (400.9, 663.1) ^*	223.2 (163.1, 318.9)	345.9 (229.9, 383.8)	211.1 (178.3, 275.8)
ALT(U/L)	75.4 (68.5, 89.5)	124.0 (109.6, 165.2) ^*	53.9 (46.2, 107.9)	96.8 (78.5, 210.8)	67.4 (58.9, 89.3)
Suzuki’s Score	0.75 (0, 1.62)	1.0 (0, 1.75)	1.75 (1.25, 2.00)	2.25 (2.0, 3.25) ^*†	1.0 (0.37, 2.0)^‡