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Hepatic elastography

Harriet S Cheng, Marius Rademaker
Increasingly, existing evidence indicates that methotrexate-associated liver injury is related to comorbid risk factors such as diabetes, alcoholism, and obesity, rather than to methotrexate itself. Despite this fact, significant effort continues to be expended in the monitoring of low-dose methotrexate in patients with psoriasis. The gold standard investigation has been liver biopsy, but this is associated with significant morbidity and mortality. As methotrexate-induced liver injury is uncommon, the risk/benefit ratio of liver biopsy has been questioned...
2018: Psoriasis: Targets and Therapy
Xinping Ren, Shujun Xia, Zhongxin Ni, Weiwei Zhan, Jianqiao Zhou
BACKGROUND: Evaluation of liver fibrosis is important to assess prognosis and guide the treatment for chronic hepatitis B. OBJECTIVE: To analyze and compare transient, point, and two-dimensional (2D) shear wave elastography techniques in grading the liver fibrosis. METHODS: Based on the severity of liver inflammation and fibrosis (Scheuer criteria), 158 patients with chronic hepatitis B were assigned into group 1 (either G or S classification < 2) or group 2 (either G or S classification ≥ 2)...
May 17, 2018: La Radiologia Medica
Ana Carolina Cardoso, Renata M Perez, Claudio de Figueiredo-Mendes, Nathalie Carvalho Leite, Henrique Sergio Moraes Coelho, Cristiane A Villela-Nogueira
A novel controlled attenuation parameter (CAP) using FibroScan® has been developed for assessment of liver steatosis. The aim was to evaluate the frequency and associated factors for moderate/severe steatosis evaluated by CAP in CHC patients submitted to transient elastography (TE) by FibroScan® . CHC patients underwent TE with CAP evaluation. The classification of steatosis was defined as: CAP < 222 dB/m = S0; CAP ≥ 222 dB/m and <233dB /m = S1; ≥233 dB/m <290dB/m = S2 and >= 290 dB/m = S3...
May 16, 2018: Journal of Viral Hepatitis
Felix Piecha, Mattias Mandorfer, Teresa Peccerella, Ann-Kathrin Ozga, Tanja Poth, Anna Vonbank, Helmut Karl Seitz, Vanessa Rausch, Thomas Reiberger, Sebastian Mueller
Liver stiffness (LS) as measured by transient elastography is increasingly used to non-invasively assess liver fibrosis. However, LS is efficiently modulated by confounders like arterial and portal pressure (PP). We here study the effect of acute hemodynamic changes on LS (measured by µFibroscan) in a rodent model of cirrhosis in response to pharmacological modulation of PP by losartan, NO-donors and propranolol. Additionally, changes of LS and the hepatic venous pressure gradient (HVPG) under propranolol therapy were assessed with regard to clinical outcomes in a human cohort of n=38 cirrhotic patients...
May 10, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
María Ángeles Jiménez-Sousa, Ana Zaida Gómez-Moreno, Daniel Pineda-Tenor, Luz Maria Medrano, Juan José Sánchez-Ruano, Amanda Fernández-Rodríguez, Tomas Artaza-Varasa, José Saura-Montalbán, Sonia Vázquez-Morón, Pablo Ryan, Salvador Resino
The polymorphisms at the α-chain of the IL-7 receptor (IL7RA) have been related to T-cell homeostasis and development and may contribute to immune system deregulation. In the present study, we analyzed the association between IL7RA polymorphisms and the progression of liver fibrosis in patients infected with HCV. We carried out a retrospective study with a design consisting of repeated measurements in 187 HCV-infected patients, to study the risk prediction of liver fibrosis progression using genetic factors...
2018: PloS One
Li-Ting Xie, Dan-Xia Xu, Guo Tian, Li-Yun Zhong, Qi-Yu Zhao, Qing-Hong Ke, Tian-An Jiang
BACKGROUND: To date, liver congestion is one of the most significant clinical diseases. However, few studies have profoundly investigated the development, pathology, and prognosis of the important problems associated with acute hepatic congestion. AIMS: To explore the value of noninvasive two-dimensional shear wave elastography (2D-SWE) for assessing acute liver congestion in an animal model. METHODS: Six healthy Bama mini-pigs were used for this research and randomly divided into the experimental group and control group...
May 8, 2018: Digestive Diseases and Sciences
Kun Wang, Xue Lu, Hui Zhou, Yongyan Gao, Jian Zheng, Minghui Tong, Changjun Wu, Changzhu Liu, Liping Huang, Tian'an Jiang, Fankun Meng, Yongping Lu, Hong Ai, Xiao-Yan Xie, Li-Ping Yin, Ping Liang, Jie Tian, Rongqin Zheng
OBJECTIVE: We aimed to evaluate the performance of the newly developed deep learning Radiomics of elastography (DLRE) for assessing liver fibrosis stages. DLRE adopts the radiomic strategy for quantitative analysis of the heterogeneity in two-dimensional shear wave elastography (2D-SWE) images. DESIGN: A prospective multicentre study was conducted to assess its accuracy in patients with chronic hepatitis B, in comparison with 2D-SWE, aspartate transaminase-to-platelet ratio index and fibrosis index based on four factors, by using liver biopsy as the reference standard...
May 5, 2018: Gut
Leandro C Mendes, Paulo A Ferreira, Noelle Miotto, Letícia Zanaga, Maria S Lazarini, Eduardo S L Gonçales, Marcelo N Pedro, Fernando L Gonçales, Raquel S B Stucchi, Aline G Vigani
BACKGROUND AND OBJECTIVE: Controlled attenuation parameter (CAP) diagnostic performance for steatosis grading has been controversial and considerable observer-related variability in liver biopsy has been reported. This is a subanalysis of a larger chronic hepatitis C study on noninvasive fibrosis staging. MATERIALS AND METHODS: Patients were prospectively enrolled for paired liver biopsy and transient elastography. Biopsy fragments were subjected to digital morphometric steatosis quantification...
April 30, 2018: European Journal of Gastroenterology & Hepatology
Rabab Fouad, Tamer Elbaz, Shereen Abdel Alem, Aisha Elsharkawy, Mohamed Negm, Marwa Khairy, Mohamed Hassany, Ahmed Cordie, Wafaa El Akel, Gamal Esmat
BACKGROUND: Elastography point quantification (ElastPQ) is a newly noninvasive method incorporated into a conventional ultrasound system for staging of liver fibrosis in patients with chronic liver diseases. AIM: The aim was to evaluate ElastPQ reproducibility and its accuracy in staging of liver fibrosis in hepatitis C virus (HCV) patients in comparison with transient elastography (TE) and fibrosis scores [FIB-4 and aspartate aminotransferase-to-platelet ratio index (APRI)] using liver biopsy as a reference standard and also to predict the sensitivity and specificity of ElastPQ as well as proposing a cut-off for advanced fibrosis...
May 1, 2018: European Journal of Gastroenterology & Hepatology
Yoshihiko Tachi, Takanori Hirai, Yuko Kojima, Yoji Ishizu, Takashi Honda, Teiji Kuzuya, Kazuhiko Hayashi, Masatoshi Ishigami, Hidemi Goto, Yoshiaki Katano
BACKGROUND AND AIMS: Pruritus is one of the complications with chronic liver disease and markedly worsens quality of life. However, the current status of pruritus in chronic hepatitis C patients who have achieved a sustained virological response (SVR) has not been clarified sufficiently. The aim of this study was to investigate the predictors of pruritus in post-SVR patients treated with direct-acting antivirals (DAA). PATIENTS AND METHODS: In this retrospective study, we enrolled 110 hepatitis C patients with SVR who underwent serial shear wave elastography before DAA therapy and at the end of treatment...
May 2, 2018: European Journal of Gastroenterology & Hepatology
Daniel C Mellema, Pengfei Song, Randall R Kinnick, Joshua D Trzasko, Matthew W Urban, James F Greenleaf, Armando Manduca, Shigao Chen
Shear wave elastography methods are able to accurately measure tissue stiffness, allowing these techniques to monitor the progression of hepatic fibrosis. While many methods rely on acoustic radiation force to generate shear waves for 2-D imaging, probe oscillation shear wave elastography (PROSE) provides an alternative approach by generating shear waves through continuous vibration of the ultrasound probe while simultaneously detecting the resulting motion. The generated shear wave field in in vivo liver is complicated, and the amplitude and quality of these shear waves can be influenced by the placement of the vibrating probe...
May 2018: IEEE Transactions on Medical Imaging
Shereen Abdel Alem, Mohamed Said, Ismail Anwar, Zeinab Abdellatif, Tamer Elbaz, Rasha Eletreby, Mahmoud AbouElKhair, Magdy El-Serafy, Sherif Mogawer, Mona El-Amir, Mostafa El-Shazly, Adel Hosny, Ayman Yosry
BACKGROUND: Progression of recurrent hepatitis C is accelerated in liver transplant (LT) recipients. Direct acting antivirals (DAAs) have recently emerged as a promising therapeutic regimen for the treatment of hepatitis C virus (HCV) infection. Rates of sustained virological response (SVR) have drastically improved since introduction of DAAs. AIM: To elucidate the changes in liver stiffness measurement (LSM) by Transient elastography (TE) as well as ARFI elastography and fibrosis scores after DAAs treatment in LT recipients with hepatitis C virus (HCV) recurrence...
May 2, 2018: Journal of Medical Virology
María-Carlota Londoño, Lara Neves Souza, Juan-José Lozano, Rosa Miquel, Juan G Abraldes, Laura-Patricia LLovet, Alberto Quaglia, Antoni Rimola, Miquel Navasa, Alberto Sánchez-Fueyo
BACKGROUND AND AIMS: Sub-clinical inflammatory changes are commonly described in long-term transplant recipients undergoing protocol liver biopsies. The pathogenesis of these lesions remains unclear. The aim of the study was to identify the key molecular pathways driving progressive sub-clinical inflammatory liver allograft damage. PATIENTS AND METHODS: All liver recipients followed at Hospital Clínic Barcelona who were >10 years post-transplant were screened to participate in the study...
April 27, 2018: Journal of Hepatology
Huimin Dong, Changzhi Xu, Wenying Zhou, Yuan Liao, Junyan Cao, Zhaoxia Li, Bo Hu
BACKGROUND: We evaluated the performance of serum hyaluronan (HA), procollagen type III N-terminal peptide (PIIINP), type IV collagen (IVC), laminin (LN), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), compared to transient elastography (FibroScan) in predicting significant liver fibrosis. METHODS: We therefore determined 4 serum fibrosis markers, FibroScan and liver biopsy in 70 consecutive adult patients with chronic hepatitis B. According to a modified Scheuer scoring system, significant fibrosis was defined as fibrosis stage ≥S2...
April 28, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Eric J Lawitz, Angie Coste, Fred Poordad, Naim Alkhouri, Nicole Loo, Bryan J McColgan, Jacqueline M Tarrant, Tuan Nguyen, Ling Han, Chuhan Chung, Adrian S Ray, John G McHutchison, G Mani Subramanian, Robert P Myers, Michael S Middleton, Claude Sirlin, Rohit Loomba, Edna Nyangau, Mark Fitch, Kelvin Li, Marc Hellerstein
BACKGROUND & AIMS: Increased de novo lipogenesis (DNL) contributes to the pathogenesis of nonalcoholic steatohepatitis (NASH). Acetyl-CoA carboxylase catalyzes the rate-limiting step in DNL. We evaluated the safety and efficacy of GS 0976, a small molecule inhibitor of acetyl-CoA carboxylase, in patients with NASH. METHODS: In an open-label prospective study, patients with NASH (n=10) received GS-0976 20 mg orally once daily for 12 weeks. NASH was diagnosed based on a proton density fat fraction estimated by magnetic resonance imaging (MRI-PDFF) >10% and liver stiffness by magnetic resonance elastography (MRE) >2...
April 26, 2018: Clinical Gastroenterology and Hepatology
Giovanna Ferraioli, Annalisa De Silvestri, Thomas Reiberger, Simon D Taylor-Robinson, Robert J de Knegt, Laura Maiocchi, Ruxandra Mare, Theresa Bucsics, Sebastiana Atzori, Carmine Tinelli, Ioan Sporea
BACKGROUND: Assessment of liver stiffness provides important diagnostic and prognostic information in patients with chronic liver disease. AIMS: To investigate whether the use of quality criteria (i) improves the concordance between transient elastography (TE) and a novel point shear wave elastography technique (ElastPQ® ) and (ii) impacts on the performance of ElastPQ® for liver fibrosis staging using TE as the reference standard. METHODS: In this multicenter retrospective study, data of patients undergoing liver stiffness measurements (LSM) in five European centers were collected...
April 4, 2018: Digestive and Liver Disease
Davide Ippolito, Valentina Schiavone, Cammillo Roberto Talei Franzesi, Alessandra Silvia Casiraghi, Silvia Girolama Drago, Luca Riva, Sandro Sironi
PURPOSE: To determine the value of real-time elastography (RTE) in the assessment of liver stiffness in patients with chronic viral hepatitis, correlating RTE data with the extent of fibrosis based on biopsy findings (Ishak score). METHODS: We evaluated 98 patients (45-75 years) with chronic viral hepatitis (51 HCV, 47 HBV) by using ultrasonography (US) study combined with RTE analysis. In the RTE images, relative tissue stiffness is expressed, according to color scale, with soft areas represented in green/red colors and hard areas in blue...
April 26, 2018: Digestive Diseases
Sheng-Di Wu, Li-Li Liu, Ji-Lin Cheng, Yun Liu, Li-Sha Cheng, Si-Qi Wang, Wei Ma, Li-Ping Chen, Yu-Jen Tseng, Ji-Yao Wang, Xi-Zhong Shen, Wei Jiang
The correlation between improvement in longitudinal liver stiffness and fibrosis regression has not been properly evaluated during long-term antiviral therapy in chronic hepatitis B (CHB) patients. In this study, liver stiffness was serially performed by FibroScan® every 26 weeks in a prospective cohort of CHB patients receiving entecavir. Results were compared with liver biopsies at baseline and week 78. A total of 120 treatment-naïve CHB patients were analyzed, in which 54 (45%) patients had fibrosis regression at 78 weeks of antiviral therapy...
April 25, 2018: Clinical and Experimental Medicine
Jie-Yang Jin, Yu-Bao Zheng, Jian Zheng, Jing Liu, Yong-Jiang Mao, Shi-Gao Chen, Zhi-Liang Gao, Rong-Qin Zheng
OBJECTIVES: To evaluate accuracy of two-dimensional shear wave elastography (2D SWE) and develop and validate a new prognostic score in predicting prognosis of acute-on-chronic liver failure (ACLF) patients. METHODS: From 1 October 2013 to 30 September 2015, we consecutively enrolled 290 patients, sequentially collected data (including 2D SWE, ultrasound parameters, laboratory data and prognostic scores) and recorded patients' outcome (recovering/steady or worsening) during a 90-day follow-up period...
April 25, 2018: European Radiology
Y Lin, H Ding, Y Zhuang, Y Zhang, Y L Zhu, W P Wang
Objective: To evaluate the diagnostic value of two-dimensional shear wave elastography(2D-SWE)in the assessment of hepatic fibrosis in a large-scale clinical setting. Methods: A total of 1 079 subjects who underwent partial hepatectomy were examined with 2D-SWE to measure liver stiffness before operation and the liver stiffness measurements were compared with histologic findings.The published cutoff values of liver stiffness examined with 2D-SWE were used as a reference, as 7.2, 9.2, and 10.4 kPa for diagnosing substantial fibrosis(S2), severe fibrosis(S3), and cirrhosis(S4), respectively...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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