Introduction: Sonazoid is an ultrasound contrast microbubbles which is known to be phagocytosed by macrophages, specifically by Kupffer cells in the liver. We examined the possibility of semi-quantifying Kupffer cell function by measuring the signal intensity in the liver parenchyma using Sonazoid-enhanced ultrasonography. Number of Kupffer cell was counted by microscopy using immune-stained section of the liver.
Methods: Patients with normal liver (NL) (n=88), chronic hepatitis (CH) (n=73), liver cirrhosis (LC) (n=74) were included. Sonazoid was administered at 0.0075ml/kg as an intravenous bolus. Twenty min. after injection, signal intensity (dB) in the liver and spleen was measured. Results: The signal intensity in the liver parenchyma (L) was -28.8±3.3 in NL, -23.6±3.7 in CH and -26.1±4.0 in LC, respectively. Those which in the spleen (S) was -24.2±4.5 in NC, -23.1±3.8 in CH, -21.3±4.3 in LC, respectively. The signal intensity of liver-to-spleen (LS) ratio was 0.2±3.5 in NC, -0.6±4.0 in CH, -4.3±4.4 in LC, respectively. Number of Kupffer cells were compatible in the three patients groups. Conclusions: Our results suggest that number of Kupffer cell was not decreased in patients with chronic liver disease, but phagocytic dysfunction was noted in patients with chronic liver disease. It might be suggested that immunodeficiency against bacteria or lipopolysaccharide via portal vein from intestines in patients with liver disease depends on Kupffer cell phagocytic dysfunction. Sonazoid can be useful to know immune-function of the liver.
Key Words: Kupffer Cell, Chronic liver disease, ultrasound, contrast microbubble, phagocytosis
