Ultrasound in medicine & biology · 2025
The Bubble-Destruction Curve Obtained Using Contrast-Enhanced Ultrasound is Useful for Assessing Liver Fibrosis and Identifying At-risk MASH in Patients With MASLD.
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Wakui Noritaka, Ogino Yu, Kamiyama Naohisa, Oguri Takuma, Uchimura Tomoya, Kudo Takahide, Maruyama Kenichi, Nagumo Hideki, Yoshimine Naoyuki, Mouri Kunihide, Kobayashi Kojiro, Mukozu Takanori, Matsui Teppei, Nagai Hidenari, Igarashi Yoshinori, Matsuda Takahisa
Аннотация
OBJECTIVE: Metabolic-dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic-dysfunction-associated steatohepatitis (MASH), are becoming increasingly prevalent, with liver fibrosis (FIB) being a predictor of poor prognosis. Non-invasive tools for assessment of FIB and early detection of at-risk MASH are essential for effective clinical management. This study evaluated the clinical usefulness of a novel ultrasound (US)-based analytical tool, the bubble-destruction curve, which is derived using contrast-enhanced US (CEUS), for non-invasive assessment of liver FIB and identification of at-risk MASH in patients with MASLD.
METHODS: Ninety-five patients with biopsy-proven MASLD underwent CEUS using Sonazoid as the contrast agent. Flash imaging was performed during the post-vascular (Kupffer) phase to generate the bubble-destruction curve, which calculates three parameters: bubble-destruction depth (BDD), bubble-destruction slope and amount of bubble accumulation. These values were analyzed in relation to histological staging of FIB, blood biomarkers, elastography parameters and the presence of at-risk MASH.
RESULTS: BDD showed a significant correlation with histological FIB stage, shear wave elastography and the FIB-4 index. The diagnostic performance of BDD for cirrhosis (F4) yielded an area under the curve of 0.92. A predictive model that combines BDD, aspartate aminotransferase (AST) and sex, called the AS-BDD-MASH score, demonstrated high diagnostic accuracy for at-risk MASH, with an area under the receiver-operating characteristic curve of 0.847.
CONCLUSION: The bubble-destruction curve derived from CEUS is a feasible and accurate approach for evaluating liver FIB in patients with MASLD. Furthermore, a composite model combining BDD derived from the bubble-destruction curve with AST and sex demonstrated good diagnostic accuracy for identifying at-risk MASH.
METHODS: Ninety-five patients with biopsy-proven MASLD underwent CEUS using Sonazoid as the contrast agent. Flash imaging was performed during the post-vascular (Kupffer) phase to generate the bubble-destruction curve, which calculates three parameters: bubble-destruction depth (BDD), bubble-destruction slope and amount of bubble accumulation. These values were analyzed in relation to histological staging of FIB, blood biomarkers, elastography parameters and the presence of at-risk MASH.
RESULTS: BDD showed a significant correlation with histological FIB stage, shear wave elastography and the FIB-4 index. The diagnostic performance of BDD for cirrhosis (F4) yielded an area under the curve of 0.92. A predictive model that combines BDD, aspartate aminotransferase (AST) and sex, called the AS-BDD-MASH score, demonstrated high diagnostic accuracy for at-risk MASH, with an area under the receiver-operating characteristic curve of 0.847.
CONCLUSION: The bubble-destruction curve derived from CEUS is a feasible and accurate approach for evaluating liver FIB in patients with MASLD. Furthermore, a composite model combining BDD derived from the bubble-destruction curve with AST and sex demonstrated good diagnostic accuracy for identifying at-risk MASH.