Liver cirrhosis: evaluation of haemodynamic changes using an ultrasound contrast agent

Liver cirrhosis is associated with haemodynamic changes. Using Levovist, we measured and compared Doppler signal arrival and peak enhancement times in the hepatic vein of patients with cirrhosis (n=12) or chronic liver disease (n=16) and in 12 healthy subjects. There were six patients with Child stage A, one patient with B, and five patients with C. The signal was recorded starting 20 s before contrast infusion until 2 h 20 min after its end. A software of the ultrasound (US) machine automatically sampled time-intensity values. Arrival times were significantly shorter (P<0.001) in cirrhotic than non-cirrhotic (chronic liver disease+controls) and in patients with Child stage C compared with A. Differences in peak enhancement were weakly significant between cirrhotic and chronic patients (P<0.04) and highly significant between the former and controls (P<0.001), whereas differences between Child stages C and A were not significant (P>0.05). Finally, cirrhotic patients had arrival times consistently shorter than 17 s. Automatic time-intensity curve analysis made measurements objective and conceptual error systematic, thus identifiable. Analysis of the passage of Levovist at the hepatic vein can thus become a non-invasive, well-tolerated and cost-effective diagnostic and monitoring tool in a larger number of patients with liver disease