The use of modern ultrasound tools such as Power Doppler Imaging (PDI) and Microvascular Imaging (MVI) in addition to color-coded Doppler sonography (CCDS) and B-mode in the detection and evaluation of the hepatic artery

Abstract

Objective:

To evaluate the contribution of modern ultrasound imaging tools such as PDI or MVI in improving detection rate, anatomical visualization, and spectral analysis of the hepatic artery.

Methods:

The retrospective single-center study analyzed 40 patients undergoing regular ultrasound control in pre-existing vascular diseases of the liver and after liver transplantation or ablative interventions with furthermore limited examination conditions due to the patient's physique or irregular vascular status after medical treatment such as referred to above. To deal with these conditions, PDI as well as MVI were performed in addition to the standardized B-mode and CCDS. Image quality interpretation was obtained retrospectively by two advanced physicians, evaluating detection rate, anatomical visualization of the vessel itself and artefact-free spectral analysis of the hepatic artery.

Results:

All forty patients (28 men, 13 women, age 23–84 years, mean 60 ± 15 years, median 61 years) showed limited examination conditions and underwent analysis of the resistive index (RI) of the hepatic artery (0.56–0.77, mean 0.67 ± 0.06, median 0.67) by using CCDS, as well as PDI and MVI. The reading addressing the image quality resulted in an average value of 2.74 (median 3.00) ± 0.82 for CCDS in the standard device versus an average value of 3.70 ± 0.83 (median 4.00) in the competing device by combining PDI and MVI scores and when addressed separately 3.56 ± 1.02 (median 4.00) for PDI versus 3.58 ± 1.02 (4.00) for MVI. Overall image quality of the competing device combining PDI and MVI was significantly superior to the standard device only using CCDS for both readers in the detection and evaluation of the hepatic artery (p < 0.01) by providing a strong inter-reader reliability for each evaluation.

Conclusion:

Combination of PDI and MVI can improve detection and visualization of the hepatic artery and its anatomy in compromised examination settings, as well as artefact-free spectral analysis detecting hemodynamic changes.