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Cirrhosis imaging

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https://www.readbyqxmd.com/read/29133247/contrast-enhanced-ultrasound-identifies-hepatocellular-carcinoma-in-cirrhosis-a-large-multicenter-retrospective-study
#1
Eleonora Terzi, Massimo Iavarone, Maurizio Pompili, Letizia Veronese, Giuseppe Cabibbo, Mirella Fraquelli, Laura Riccardi, Ludovico De Bonis, Angelo Sangiovanni, Simona Leoni, Maria Assunta Zocco, Sandro Rossi, Nicola Alessi, Stephanie R Wilson, Fabio Piscaglia, Alessandro Granito, Veronica Salvatore, Francesco Tovoli, Matteo Angelo Manini, Gian Lodovico Rapaccini, Maria Elena Ainora, Valentina Ravetta, Giorgia Ghittoni, Agostino Ventra, Giuseppe Mogavero
BACKGROUND & AIMS: The use of contrast enhanced ultrasound (CEUS) for the diagnosis of hepatocellular carcinoma (HCC) in cirrhosis was questioned for the risk of false positive diagnosis in case of cholangiocarcinoma. The American College of Radiology has recently released a scheme (CEUS LI-RADS) classifying lesions at risk for HCC investigated by CEUS. Aim of the present study was to validate this LI-RADS scheme for the diagnosis of HCC. METHODS: A total of 1006 nodules in 848 patients with chronic liver disease at risk for HCC collected in 5 Italian centers were retrospectively analyzed...
November 10, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29132522/nonalcoholic-fatty-liver-disease
#2
REVIEW
Patrick H Sweet, Teresa Khoo, Steven Nguyen
Nonalcoholic fatty liver disease (NAFLD) defines a condition of hepatic steatosis with or without hepatic injury. NAFLD is increasing in prevalence worldwide and presents a public health burden. Most patients are asymptomatic, although some present with fatigue and right upper quadrant pain. NAFLD is discovered incidentally when patients have elevated liver enzymes or fatty liver is seen on imaging modalities. Imaging studies can confirm fatty deposits in the liver, but needle biopsy is needed to determine degree of inflammation...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29129265/does-intra-tumoural-fat-on-mri-predict-visibility-of-small-%C3%A2-3-cm-hepatocellular-carcinomas-during-ultrasound-guided-tumour-ablation
#3
T C H Hui, I K H Huang, W K Lau, U Pua
AIM: To assess if intra-tumoural fat on magnetic resonance imaging (MRI) affects the ultrasonographic (US) visibility of small (≤3 cm) hepatocellular carcinomas (HCC) during radiofrequency ablation (RFA). MATERIALS AND METHODS: Institutional review board approval was obtained. A retrospective review of all patients who underwent image-guided ablation between 1 January 2010 and 31 April 2015 was performed. Patients with HCC who underwent US RFA were included. Inclusion criteria included small tumours (≤3 cm), treatment-naive cases or new focus of HCC in a different and untreated segment, and pre-procedural MRI...
November 10, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/29123845/cortical-blindness-induced-by-hepatic-encephalopathy-case-report-and-review-of-published-case-reports
#4
Shaohua Cheng-Tagome, Akitaka Yamamoto, Kei Suzuki, Naoyuki Katayama, Hiroshi Imai
Case: Cortical blindness induced by hepatic encephalopathy is an extremely rare complication and its epidemiology has not been studied in great detail. We report a 63-year-old man with liver cirrhosis who developed sudden bilateral visual impairment. Outcome: On arrival at hospital, the patient had orientation disturbance, slurred speech, and mild disturbance of consciousness with impaired vision (light sense). He had no focal neurological deficits except for bilateral blindness...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121718/non-invasive-assessment-of-liver-changes-in-eisenmenger-patients
#5
Siegrun Mebus, Nicole Nagdyman, Johanna Kügel, Reinhart Zachoval, Siegmund Lorenz Braun, Guido Haverkämper, Bernd Opgen-Rhein, Felix Berger, Sophia Horster, Jörg Schoetzau, Claudia Pujol Salvador, Ulrike Bauer, John Hess, Peter Ewert, Harald Kaemmerer
BACKGROUND: Eisenmenger syndrome as a severe form of cyanotic congenital heart disease results in a complex multisystemic disorder. Due to increased systemic venous pressure and the inability to ensure systemic perfusion and metabolic requirements, the liver may develop congestion, fibrosis or cirrhosis. This study aimed to assess hepatic abnormalities in Eisenmenger patients non-invasively. METHODS AND RESULTS: 10 adults with Eisenmenger syndrome (six female; median age 44...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118563/cardiac-dysfunction-as-an-early-predictor-of-portal-hypertension-in-chronic-hepatitis-c
#6
Cecilia Marconi, Mattia Bellan, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Lisa Franzosi, Mario Pirisi
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29116341/shear-wave-liver-elastography
#7
Richard G Barr
Chronic liver disease is a substantial world-wide problem. Its major consequence is increasing deposition of fibrous tissue within the liver leading to the development of cirrhosis with its consequences of portal hypertension, hepatic insufficiency, and hepatocellular carcinoma. The stage of liver fibrosis is important to determine prognosis, surveillance, prioritize for treatment, and potential for reversibility. The process of fibrosis is dynamic and regression of fibrosis is possible with treatment of the underlying conditions...
November 7, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29103478/liver-investigations-updating-on-us-technique-and-contrast-enhanced-ultrasound-ceus
#8
REVIEW
Valentina Battaglia, Rosa Cervelli
Over the past few years, the cross sectional imaging techniques (Computed Tomography - CT and Magnetic Resonance - MR) have improved, allowing a more efficient study of focal and diffuse liver diseases. Many papers had been published about the results of a routinely clinical use of the dual source/dual energy CT techniques and the use of hepatobiliary contrast agents in MR liver studies. As a consequence, these new improvements have diverted the attention away from the Ultrasound technique and its technical and conceptual evolutions...
November 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29102862/reno-portal-shunt-for-liver-transplant-an-alternative-inflow-for-recipients-with-grade-iii-iv-portal-vein-thrombosis-tips-for-a-better-outcome
#9
Mustafa Nazzal, Yifei Sun, Obi Okoye, Laurence Diggs, Neil Evans, Tamara Osborn, Kambiz Etesami, Chintalapati Varma
INTRODUCTION: Portal vein thrombosis (PVT) poses an extremely difficult problem in cirrhotic patients who are in need of a liver transplant. The prevalence of PVT in patients with cirrhosis ranges from 0.6% to 26% Nery et al. (2015) [1]. The presence of PVT is associated with more technically difficult liver transplant and in certain cases can be a contraindication to liver transplant. The only option for these patients with extensive PVT would be a multi-visceral transplant, the later unfortunately has a much higher morbidity and mortality compared to liver only transplant Smith et al...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29101980/acr-appropriateness-criteria-%C3%A2-chronic-liver%C3%A2-disease
#10
Jeanne M Horowitz, Ihab R Kamel, Hina Arif-Tiwari, Sumeet K Asrani, Nicole M Hindman, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani
Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis. Transient elastography, ultrasound elastography with acoustic radiation force impulse, and MR elastography are modalities that can assess for hepatic fibrosis. Although all international organizations recommend ultrasound for screening for hepatocellular carcinoma, ultrasound is particularly limited for identifying hepatocellular carcinoma in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29097814/multi-sensory-integration-impairment-in-patients-with-minimal-hepatic-encephalopathy
#11
Kyoungwon Seo, Dae Won Jun, Jae-Kwan Kim, Hokyoung Ryu
Paper-and-pencil-based psychometric tests are the gold standard for diagnosis of cognitive dysfunction in liver disease. However, they take time, can be affected by demographic factors, and lack ecological validity. This study explored multi-sensory integration ability to discriminate cognitive dysfunction in cirrhosis. Thirty-two healthy controls and 30 cirrhotic patients were recruited. The sensory integration test presents stimuli from two different modalities (e.g., image/sound) with a short time lag, and subjects judge which stimuli appeared first...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29096656/liver-resection-for-hepatocellular-carcinoma-in-patients-with-hematological-malignancies
#12
Hui-Chen Lin, Yang-Shen Yang, Chieh-Lin Jerry Teng, Ching-Hui Shen, Yee-Gee Jan, Shao-Bin Cheng, Cheng-Chung Wu, Yi-Ling Lin, Chu-Chun Huang, Fang-Ku P'eng
BACKGROUND: Improvements in antimetabolite drugs have prolonged the survival of patient with hematological malignancies. However, these drugs may have hepatotoxic side effects and may induce acute liver failure, chronic liver fibrosis, cirrhosis, or even hepatocellular carcinoma (HCC). Although liver resection remains a curative option for HCC, its role in HCC with hematological malignancies has never been fully explored. METHODS: A retrospective review of 1725 patients who underwent curative liver resection for newly diagnosed HCC between 1994 and 2016 was conducted...
November 2, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29093623/presence-of-columnar-lined-esophagus-is-negatively-associated-with-the-presence-of-esophageal-varices-in-japanese-alcoholic-men
#13
Akira Yokoyama, Kenro Hirata, Rieko Nakamura, Tai Omori, Takeshi Mizukami, Junko Aida, Katsuya Maruyama, Tetsuji Yokoyama
AIM: To determine whether the presence of columnar-lined esophagus (CLE) is associated with the presence of esophageal varices (EVs) in male Japanese alcoholics. METHODS: The subjects were 1614 Japanese alcohol-dependent men (≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29091004/performing-gadoxetic-acid-enhanced-mri-after-ct-for-guiding-curative-treatment-of-early-stage-hepatocellular-carcinoma-a-cost-effectiveness-analysis
#14
Chong Hyun Suh, Kyung Won Kim, Seong Ho Park, So Yeon Kim, Dong-Cheol Woo, Sangjin Shin, Junhee Pyo, Atul B Shinagare, Nikhil H Ramaiya, Young-Suk Lim
OBJECTIVE: We determined the cost-effectiveness of two different diagnostic imaging strategies in guiding curative treatment of early-stage hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We developed a decision analytic model using as its starting point a cohort of patients aged 55 years with early-stage HCC detected at dynamic multiphasic CT and with Child-Pugh class A cirrhosis. The model compared two strategies on the initial workup: conventional CT strategy using dynamic multiphasic CT only and gadoxetic acid-enhanced MRI strategy using additional gadoxetic acid-enhanced MRI after initial CT...
November 1, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29082750/assessment-of-adherence-to-baseline-quality-measures-for-cirrhosis-and-the-impact-of-performance-feedback-in-a-regional-va-medical-center
#15
Jennifer A Cahill, Syed Rizvi, Kia Saeian
Baseline adherence to cirrhotic quality improvement measures was assessed and a system to improve adherence with provider performance feedback was developed, with impact of feedback measured over time. A 6-year retrospective database was created of cirrhotic patients seen between 2006 and 2012, and reviewed for hepatitis A and B serologies, hepatocellular carcinoma (HCC) screening, variceal screening, and vaccinations. Cumulative performance feedback was distributed to providers. In all, 265 charts were reviewed retrospectively...
October 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29074333/improvement-of-portal-venous-pressure-in-cirrhotic-rat-livers-by-systemic-treatment-with-adipose-tissue-derived-mesenchymal-stromal-cells
#16
Sandra Brückner, Alexander Zipprich, Madlen Hempel, Antje Thonig, Fabian Schwill, Martin Roderfeld, Elke Roeb, Bruno Christ
BACKGROUND AIMS: Portal hypertension is the main cause of complications in cirrhosis caused primarily by extensive fibrosis. Both anti-fibrotic and pro-fibrotic properties of mesenchymal stromal cells (MSCs) have been described in various animal models of liver fibrosis. Therefore, the impact of MSCs on portal hypertension and fibrosis should be investigated in an animal model of liver cirrhosis. METHODS: The effect of systemic treatment with adipose tissue-derived MSCs, pre-differentiated into hepatocytic cells, was investigated in a rat model of liver cirrhosis induced by chronic inhalation of carbon tetrachloride...
October 23, 2017: Cytotherapy
https://www.readbyqxmd.com/read/29072825/nutrition-and-the-transplant-candidate
#17
REVIEW
Vera C Mazurak, Puneeta Tandon, Aldo J Montano-Loza
Cirrhosis is the most common indication for liver transplantation (LT) worldwide. Malnutrition is present in at least two-thirds of patients with cirrhosis awaiting LT. It negatively impacts survival, quality of life, and the ability to respond to stressors, such as infection and surgery. Muscle wasting or sarcopenia is the most objective feature of chronic protein malnutrition in cirrhosis, and this condition is associated with increased morbidity and mortality before and after LT. In addition to its objectivity, muscularity assessment with cross-sectional imaging studies is a useful marker of nutritional status in LT candidates, as sarcopenia reflects a chronic decline in the general physical condition, rather than acute severity of the liver disease...
November 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29072690/the-non-invasive-serum-biomarker-soluble-axl-accurately-detects-advanced-liver-fibrosis-and-cirrhosis
#18
Katharina Staufer, Mirko Dengler, Heidemarie Huber, Rodrig Marculescu, Rudolf Stauber, Carolin Lackner, Hans-Peter Dienes, Danijel Kivaranovic, Christian Schachner, Markus Zeitlinger, Beatrix Wulkersdorfer, Peter Rauch, Gerhard Prager, Michael Trauner, Wolfgang Mikulits
Soluble Axl (sAxl) was recently shown to be strongly released into the blood during liver fibrogenesis and hepatocellular carcinoma suggesting sAxl as a biomarker of liver diseases. In this study we are the first to evaluate sAxl in human serum in comparison to Enhanced Liver Fibrosis (ELF) test and transient elastography (TE; Fibroscan) for its value to detect significant (F≥2), advanced fibrosis (F≥3), and cirrhosis (F4) in different liver disease etiologies and healthy controls. To properly determine the diagnostic accuracy of sAxl, a test cohort as well as a validation cohort was employed using liver biopsy as a reference method...
October 26, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/29072497/efficacy-and-safety-of-ultrasound-guided-percutaneous-glue-embolization-in-iatrogenic-haemorrhagic-complications-of-paracentesis-and-thoracocentesis-in-cirrhotic-patients
#19
Amar Mukund, Vinay Kumar Dp, Naveen Kumar Condati, Ajeet Singh Bhadoria, Shiv Kumar Sarin
OBJECTIVE: To compare the safety and efficacy of ultrasound guided percutaneous glue (N-butyl-2-cyanoacrylate) embolization with transarterial embolization in the management of iatrogenically injured arteries while performing paracentesis or thoracocentesis in patients with chronic liver disease. METHODS: Hospital database was searched for cirrhotic patients having abdominal/thoracic wall haemorrhage following paracentesis/thoracocentesis procedure from January 2011 to June 2016...
November 8, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29069254/accuracy-of-transient-elastography-fibroscan%C3%A2-acoustic-radiation-force-impulse-arfi-imaging-the-enhanced-liver-fibrosis-elf-test-apri-and-the-fib-4-index-compared-with-liver-biopsy-in-patients-with-chronic-hepatitis-c
#20
Taisa Grotta Ragazzo, Denise Paranagua-Vezozzo, Fabiana Roberto Lima, Daniel Ferraz de Campos Mazo, Mário Guimarães Pessoa, Claudia Pinto Oliveira, Venancio Avancini Ferreira Alves, Flair José Carrilho
OBJECTIVES: Although liver biopsy is the gold standard for determining the degree of liver fibrosis, issues regarding its invasiveness and the small amount of liver tissue evaluated can limit its applicability and interpretation in clinical practice. Non-invasive evaluation methods for liver fibrosis can address some of these limitations. The aim of this study was to evaluate the accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI), enhanced liver fibrosis (ELF), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index compared with liver biopsy in hepatitis C...
October 2017: Clinics
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