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Hepatic elastography

Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Christoph Jochum, Ali Canbay, Alexander Dechêne
BACKGROUND/AIMS: Portal hypertension (PH) is a common complication of chronic liver disease and results in esophageal and gastric variceal bleeding, which is associated with a high mortality rate. Measurement of the hepatic venous pressure gradient (HVPG) is considered the gold standard for diagnosing PH and estimating the risk of varices and bleeding. In contrast, upper gastrointestinal (GI) endoscopy (UGE) can reliably demonstrate the presence of varices and bleeding. Both measures are invasive, and HVPG is mainly restricted to tertiary centers...
October 19, 2016: Digestion
Emily Etchell, Lauriane Jugé, Alice Hatt, Ralph Sinkus, Lynne E Bilston
Purpose To determine if healthy hepatic mechanical properties differ between pediatric and adult subjects at magnetic resonance (MR) elastography. Materials and Methods Liver shear moduli in 24 healthy pediatric participants (13 children aged 5-14 years [seven boys, six girls] and 11 adolescents aged 15-18 years [six boys, five girls]) and 10 healthy adults (aged 22-36 years [five men, five women]) were obtained with 3-T MR elastography at 28, 56, and 84 Hz. Relationships between shear moduli and age were assessed with Spearman correlations...
October 17, 2016: Radiology
Frank W DiPaola, Kurt R Schumacher, Caren S Goldberg, Joshua Friedland-Little, Aishwarya Parameswaran, Jonathan R Dillman
OBJECTIVES: Assess liver stiffness using ultrasound point shear wave elastography (US P-SWE) in children before and after the Fontan operation. METHODS: Eighteen children undergoing the Fontan operation were prospectively enrolled. Eight US P-SWE measurements were obtained from the right hepatic lobe before surgery, and at multiple postoperative time points. Temporally related inferior vena cava pressure (IVC) data was collected from medical records, when available...
October 17, 2016: European Radiology
Myung-Won You, Kyung Won Kim, Junhee Pyo, Jimi Huh, Hyoung Jung Kim, So Jung Lee, Seong Ho Park
We aimed to evaluate the correlation between liver stiffness measurement using transient elastography (TE-LSM) and hepatic venous pressure gradient and the diagnostic performance of TE-LSM in assessing clinically significant portal hypertension through meta-analysis. Eleven studies were included from thorough literature research and selection processes. The summary correlation coefficient was 0.783 (95% confidence interval [CI], 0.737-0.823). Summary sensitivity, specificity and area under the hierarchical summary receiver operating characteristic curve (AUC) were 87...
October 14, 2016: Ultrasound in Medicine & Biology
Norihisa Yada, Toshiharu Sakurai, Tomohiro Minami, Tadaaki Arizumi, Masahiro Takita, Satoru Hagiwara, Hiroshi Ida, Kazuomi Ueshima, Naoshi Nishida, Masatoshi Kudo
OBJECTIVE: We have reported about real-time tissue elastography (RTE), which displays relative strain by measuring the relative distortion of the tissue, and found this information to be useful for diagnosing liver fibrosis. However, its use in predicting hepatocellular carcinoma has not been reported as yet. Here, we investigated RTE to predict liver carcinogenesis in patients with chronic hepatitis C virus (HCV) infection. METHODS: We enrolled 160 patients with chronic HCV, who were followed up for 39...
2016: Digestive Diseases
Tao Wu, Ping Wang, Ting Zhang, Jian Zheng, Shuoyang Li, Jie Zeng, Masatoshi Kudo, Rongqin Zheng
BACKGROUND: Noninvasive assessment of liver fibrosis has important clinical significance. Different techniques including two-dimensional shear-wave elastography (2D SWE) and real-time tissue elastography (RTE) are reported to be useful for the noninvasive diagnosis of hepatic fibrosis. All these techniques are affected by many factors. How to choose a reasonable method needs further studies. PURPOSE: This study was conducted to comparatively assess the diagnostic performance of 2D SWE and RTE in patients with Chronic Hepatitis B (CHB) and influence of inflammation on the stiffness values obtained by both techniques, so as to objectively assess the reasonable choice between these 2 elastography techniques for noninvasive assessment of hepatic fibrosis in clinical practice...
2016: Digestive Diseases
Yundong Qu, Tao Li, Qian Ye, Lixin Zhang, Lei Wang
BACKGROUND/AIMS: To assess the accuracy of transient elastography (TE) in the prediction of esophageal varices (EV). MATERIALS AND METHODS: The literature search was conducted by using PubMed, EMBASE, Web of Science, and CENTRAL on The Cochrane Library without time or language restrictions. Terms used were "FibroScan," "transient elastography," "stiffness," and "esophageal varices." The pooled sensitivity, specificity, and other parameters were obtained using a bivariate mixed-effects regression model...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
I G Murphy, M J Graves, S Reid, A J Patterson, I Patterson, A N Priest, D J Lomas
PURPOSE: Hepatic magnetic resonance elastography (MRE) is currently a breath-hold imaging technique. Patients with chronic liver disease can have comorbidities that limit their ability to breath-hold (BH) for the required acquisition time. Our aim was to evaluate whether stiffness measurements obtained from a navigator-triggered MRE acquisition are comparable to standard expiratory breath-hold, inspiratory breath-hold or free-breathing in healthy participants. MATERIALS AND METHODS: Twelve healthy participants were imaged using the four methods on a clinical 1...
October 13, 2016: Magnetic Resonance Imaging
Zheng-Jie Xu, Jun-Ping Shi, De-Rong Yu, Li-Juan Zhu, Ji-Dong Jia, Jian-Gao Fan
INTRODUCTION: Non-alcoholic steatohepatitis (NASH) is a serious form of non-alcoholic fatty liver disease (NAFLD) that can progress to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Differentiating between non-alcoholic fatty liver (NAFL) and NASH/advanced fibrosis is an important step in the management of NAFLD. Metabolic syndrome (MS) and its components are important risk factors for NAFLD, and NASH is thought to be the hepatic injury of MS. The prevalence of NASH among NAFLD patients with MS is thought to be high...
October 14, 2016: Advances in Therapy
Zeinab A Elkabbany, Nancy S Elbarbary, Eman A Ismail, Nesrine A Mohamed, Dina Ragab, Shereen Abdel Alem, Yasmine M Ezzat, Sarah S Maurice, Noha U Hashem
AIM: To identify the prevalence and effect of hepatopathies of different etiologies among pediatric patients with type 1 diabetes mellitus (T1DM) using transient elastography (TE) and its relation to glycemic control. METHODS: One hundred T1DM patients were studied focusing on liver functions, fasting lipid profile, hemoglobin A1c (HbA1c), hepatitis C virus (HCV), serum immunoglobulins, autoimmune antibodies; anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-liver kidney microsomal antibody (anti-LKM)...
September 26, 2016: Journal of Diabetes and its Complications
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
Hye Won Lee, Sang Hoon Ahn
Chronic hepatitis B virus (HBV) infection is a major cause of cirrhosis and hepatocellular carcinoma (HCC). Applying the same strategies for antiviral therapy and HCC surveillance to all chronic hepatitis B (CHB) patients would be a burden worldwide. To properly manage CHB patients, it is necessary to identify and classify the risk for HCC development in such patients. Several HCC risk scores based on risk factors such as cirrhosis, age, male gender, and high viral load have been used, and have negative predictive values of ≥ 95%...
October 7, 2016: World Journal of Gastroenterology: WJG
So Hyun Park, So Yeon Kim, Chong Hyun Suh, Seung Soo Lee, Kyoung Won Kim, So Jung Lee, Moon-Gyu Lee
According to the increasing need for accurate staging of hepatic fibrosis, the ultrasound (US) elastography techniques have evolved significantly over the past two decades. Currently, US elastography is increasingly used in clinical practice. Previously published studies have demonstrated the excellent diagnostic performance of US elastography for the detection and staging of liver fibrosis. Although US elastography may seem easy to perform and interpret, there are many technical and clinical factors which can affect the results of US elastography...
September 2016: Clinical and Molecular Hepatology
Harald Kramer, Perry J Pickhardt, Mark A Kliewer, Diego Hernando, Guang-Hong Chen, James A Zagzebski, Scott B Reeder
OBJECTIVE: The purpose of this study was to prospectively evaluate the accuracy of proton-density fat-fraction, single- and dual-energy CT (SECT and DECT), gray-scale ultrasound (US), and US shear-wave elastography (US-SWE) in the quantification of hepatic steatosis with MR spectroscopy (MRS) as the reference standard. SUBJECTS AND METHODS: Fifty adults who did not have symptoms (23 men, 27 women; mean age, 57 ± 5 years; body mass index, 27 ± 5) underwent liver imaging with un-enhanced SECT, DECT, gray-scale US, US-SWE, proton-density fat-fraction MRI, and MRS for this prospective trial...
October 11, 2016: AJR. American Journal of Roentgenology
Agostino Colli, Mirella Fraquelli, Daniele Prati, Alessia Riva, Alessandra Berzuini, Dario Conte, Alessio Aghemo, Massimo Colombo, Giovanni Casazza
INTRODUCTION: In a perspective of economic constraints the prioritizing of patients to IFN-free regimens is mainly based on the determination of liver stiffness by transient elastography (TE). Being a continuous variable the interpretation of TE results requires the identification of cut-off values, to date set to maximize diagnostic accuracy even if such values should be better based on more helpful outcome prediction endpoints. AIM: To define the TE cut-off values in different clinical scenarios, including new IFN-free regimens, and to balance the clinical benefits versus harms in treated and untreated patients...
2016: PloS One
Suraj D Serai, Jonathan R Dillman, Andrew T Trout
Purpose To compare two-dimensional (2D) gradient-recalled echo (GRE) and 2D spin-echo (SE) echo-planar imaging (EPI) magnetic resonance (MR) elastography for measurement of hepatic stiffness in pediatric and young adult patients suspected of having liver disease. Materials and Methods In this institutional review board-approved, HIPAA-compliant study, 58 patients underwent both 2D GRE and 2D SE-EPI MR elastography at 1.5 T during separate breath holds. Liver stiffness (mean of means; in kilopascals) was measured by five blinded reviewers...
October 10, 2016: Radiology
Gamal Shiha, Alaa Ibrahim, Ahmed Helmy, Shiv Kumar Sarin, Masao Omata, Ashish Kumar, David Bernstien, Hitushi Maruyama, Vivek Saraswat, Yogesh Chawla, Saeed Hamid, Zaigham Abbas, Pierre Bedossa, Puja Sakhuja, Mamun Elmahatab, Seng Gee Lim, Laurentius Lesmana, Jose Sollano, Ji-Dong Jia, Bahaa Abbas, Ashraf Omar, Barjesh Sharma, Diana Payawal, Ahmed Abdallah, Abdelhamid Serwah, Abdelkhalek Hamed, Aly Elsayed, Amany AbdelMaqsod, Tarek Hassanein, Ahmed Ihab, Hamsik GHaziuan, Nizar Zein, Manoj Kumar
Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated...
October 6, 2016: Hepatology International
Martin L Decaris, Kelvin W Li, Claire L Emson, Michelle Gatmaitan, Shanshan Liu, Yenny Wang, Edna Nyangau, Marc Colangelo, Thomas E Angel, Carine Beysen, Jeffrey Cui, Carolyn Hernandez, Len Lazaro, David A Brenner, Scott M Turner, Marc K Hellerstein, Rohit Loomba
: Excess collagen synthesis (fibrogenesis) in the liver plays a causal role in the progression of nonalcoholic fatty liver disease (NAFLD). Methods are needed to identify patients with more rapidly progressing disease and to demonstrate early response to treatment. We describe here a novel method to quantify hepatic fibrogenesis flux rates both directly in liver tissue and non-invasively in blood. Twenty-one patients with suspected NAFLD ingested heavy water ((2) H2 O, 50 ml aliquots) 2-3 times daily for 3 to 5 weeks prior to a clinically indicated liver-biopsy...
October 5, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Javier A Cepeda, Sunil S Solomon, Aylur K Srikrishnan, Paneerselvam Nandagopal, Pachamuthu Balakrishnan, Muniratnam S Kumar, David L Thomas, Mark S Sulkowski, Shruti H Mehta
Background.  Access to hepatitis C virus (HCV) treatment is limited in low- and middle-income countries (LMICs). Noninvasive biomarkers, such as fibrosis 4 (FIB-4) and aminotransferase to platelet ratio index (APRI), are low-cost alternatives to staging liver disease and identifying treatment need in people with chronic HCV infection, but their accuracy has not been evaluated in LMICs. Methods.  We tested the accuracy of FIB-4 and APRI at validated cutoffs (FIB-4 <1.45, >3.25; APRI <0.5, >1...
September 2016: Open Forum Infectious Diseases
Sasha van Katwyk, Doug Coyle, Curtis Cooper, Kusala Pussegoda, Chris Cameron, Becky Skidmore, Stacey Brener, David Moher, Kednapa Thavorn
BACKGROUND: Liver biopsy remains the gold standard for the diagnosis of liver fibrosis, but its use as a diagnostic tool is limited by its invasive nature and high cost. OBJECTIVE: To systematically review the cost-effectiveness of transient elastography (TE) with and without controlled attenuation parameter (CAP) for the diagnosis of liver fibrosis or steatosis in patients with hepatitis B, hepatitis C, alcoholic liver disease, and non-alcoholic fatty liver disease...
October 3, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
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