scholarly journals Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study

2021 ◽  
Vol 15 (7) ◽  
pp. e0009594
Author(s):  
Yuri Costa Sarno Neves ◽  
Victor Augusto Camarinha de Castro-Lima ◽  
Davi Jorge Fontoura Solla ◽  
Vivian Simone de Medeiros Ogata ◽  
Fernando Linhares Pereira ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Yellow Fever ◽  
Previous History ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Ultrasound Elastography ◽  
Hemorrhagic Disease ◽  
Saps 3

Background Yellow fever (YF) is a hemorrhagic disease caused by an arbovirus endemic in South America, with recent outbreaks in the last years. Severe cases exhibit fulminant hepatitis, but there are no studies regarding its late-term effects on liver parenchyma. Thus, the aim of this study was to determine the frequency and grade of liver fibrosis in patients who recovered from severe YF and to point out potential predictors of this outcome. Methodology/Principal findings We followed-up 18 patients who survived severe YF during a recent outbreak (January-April 2018) in Brazil using ultrasound (US) with shear-wave elastography (SWE) at 6 months after symptoms onset. No patient had previous history of liver disease. Median liver stiffness (LS) was 5.3 (4.6–6.4) kPa. 2 (11.1%) patients were classified as Metavir F2, 1 (8.3%) as F3 and 1 (8.3%) as F4; these two last patients had features of cardiogenic liver congestion on Doppler analysis. Age and cardiac failure were associated with increased LS (p = 0.036 and p = 0.024, respectively). SAPS-3 at ICU admission showed a tendency of association with significant fibrosis (≥ F2; p = 0.053). 7 patients used sofosbuvir in a research protocol, of which none showed liver fibrosis (p = 0.119). Conclusions/Significance We found a low frequency of liver fibrosis in severe YF survivors. US with SWE may have a role in the follow up of patients of age and / or with comorbidities after hospital discharge in severe YF, a rare but reemergent disease.

scholarly journals Motion effects on the measurement of stiffness on ultrasound shear wave elastography: a moving liver fibrosis phantom study

2018 ◽  
Vol 1 (1) ◽  
pp. 14 ◽  
Author(s):  
Hyun Joo Shin ◽  
Myung-Joon Kim ◽  
Choon-Sik Yoon ◽  
Kwanseop Lee ◽  
Kwan Sik Lee ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Normal Liver ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Lower Velocity ◽  
Velocity Motion

Aims: To evaluate the differences between shear wave velocities (SWVs) measured with ultrasound elastography during the continuous motion using liver fibrosis phantoms.Materials and methods: Elasticities were measured with convex and linear transducers of supersonic shear wave imaging (SSI) and acoustic radiation force impulse imaging (ARFI) using liver elasticity phantoms (3.0 and 16.9 kPa) at depths of 2, 3, 4, and 5 cm. Motion velocities were 30 and 60 rpm with the phantoms in an upright position on the Orbital shaker. To simulate different directional motion, the phantoms were laid on their side on the shaker. The values between moving and static status were compared, and the number of measurement failure was counted. Results: In SSI, the convex transducer was less affected by motion at 30 rpm with the 3 kPa phantom. In the higher velocity motion and in the higher stiffness phantom, most values from SSI were different comparing with static status, and there was a tendency for elasticity values to increase during movement. In ARFI, there were frequent measurement failures without stable results during the motion.Conclusions: Motion affected the measurement of elasticity differently in SSI and ARFI, according to the velocity, direction of the motion, and phantom stiffness. The convex transducer of SSI was less affected by motion in lower velocity motion and when using normal liver stiffness phantom.

Shear-wave ultrasound elastography of the liver in normal-weight and obese children

2017 ◽  
Vol 58 (12) ◽  
pp. 1511-1518 ◽  
Author(s):  
Smita Sane Bailey ◽  
Mostafa Youssfi ◽  
Mittun Patel ◽  
Houchun H Hu ◽  
Gabriel Q Shaibi ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Normal Weight ◽  
Ultrasound Elastography ◽  
Qualitative Assessment ◽  
Imaging Biomarker ◽  
Imaging Biomarkers ◽  
Obese Children

Background The identification and subsequent management of liver diseases in children is challenging due to the lack of non-invasive imaging biomarkers. Ultrasound shear-wave elastography (US-SWE) is an emerging imaging technique which can quantitatively assess liver stiffness and may be useful as a tool in the management of liver disease in overweight and obese children. Purpose To evaluate US-SWE velocities of the liver in normal-weight and obese children, to correlate US-SWE findings with age and body-mass-index (BMI), and to compare US-SWE values with qualitative assessment (i.e. normal versus abnormal echogenicity) of the liver by conventional US. Material and Methods A cohort of 300 children (mean age, 9.9 ± 5.3 years; age range, 0.06–18.9 years) were studied, comprising 176 normal-weight and 124 obese participants. In each patient, both US-SWE and conventional US of the liver were obtained. Three pediatric radiologists individually and in consensus determined whether liver parenchyma was of normal or abnormal echogenicity. Results US-SWE velocities differed between normal-weight and obese children (1.08 ± 0.14 versus 1.44 ± 0.39 m/s; P < 0.001), but not by gender. Multivariate linear regression demonstrated US-SWE velocity to be primarily associated with age in normal-weight children ( P < 0.05) and with BMI in obese children ( P < 0.001). In the obese group, mean US-SWE velocity was statistically higher in participants with abnormal echogenic livers than in those with normal-appearing livers (1.53 ± 0.38 vs. 1.17 ± 0.27). The difference was not significant in the normal-weight group. Conclusion US-SWE provides a useful quantitative imaging biomarker for evaluating liver stiffness in children.

scholarly journals NON INVASIVE ASSESSMENT OF LIVER FIBROSIS USING ULTRASOUND POINT SHEAR WAVE ELASTOGRAPHY

2021 ◽  
pp. 1-3
Author(s):  
Sunil Patel ◽  
Chinmay Kulkarni ◽  
Srikanth Moorthy
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Shear Wave ◽  
Hepatic Fibrosis ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Non Invasive ◽  
Elevated Liver Enzymes ◽  
Clinically Significant

Aim To prospectively determine the sensitivity, specificity and accuracy of point shear wave elastography as a non-invasive method in the diagnosis of clinically significant hepatic fibrosis with various etiologies of liver using liver biopsy as gold standard.To determine the stiffness cut-off values for point shear wave elastography (pSWE) diagnosis of clinically significant hepatic fibrosis. Methods Fifty patients with elevated liver enzymes were examined by point shear wave Elastography and they subsequently underwent percutaneous liver biopsy. Ultrasound Elastography findings were correlated with the histopathology fibrosis staging (METAVIR / Brunt Scoring) Results Liver stiffness value of >7.6 kPa was cut-off for clinically significant fibrosis and had a sensitivity of 92%, a specificity of 78.3% and an accuracy of 86%. Conclusions ElastPQ is a non-invasive and sensitive technique for determining the clinically significant liver fibrosis in patients with various etiologies.

The impact of direct-acting antivirals on liver fibrosis in Egyptian hepatitis C virus patients: a single center experience

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia Abdelaaty Abdelkader ◽  
Amira Mahmoud AlBalakosy ◽  
Ahmed Fouad Helmy Sherief ◽  
Mohamed Soliman Gado
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Treatment Unit ◽  
Non Invasive ◽  
One Year ◽  
The Impact

Abstract Background Hepatitis C virus (HCV) infection affects approximately 170 million people worldwide, causing liver cirrhosis and hepatocellular carcinoma (HCC) and leading to liver transplantation and ultimately death. Accurate evaluation of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with DAAs. Objectives The aim beyond this study is to evaluate the changes in liver stiffness in hepatitis C Egyptian patients before and at least one year after treatment with DAAs using transient elastography and non-invasive liver fibrosis indices as FIB-4 and APRI scores. Patients and methods The present study was conducted on 100 patients with chronic hepatitis C patients attended to Ain Shams University Hospitals, Viral hepatitis treatment unit between October 2017 and December 2018, who were followed-up during treatment and after treatment for at least one year (retrospective and prospective study). Total number of cases during the study period was 117 patients. 17 patients were excluded from the study due to missed follow-up. Eventually, 100 patients were enrolled in the study fulfilling the inclusion criteria. Results The mean age of our patients is 47.9 years with Male predominance (52 males and 48 females). There was a significant improvement of, platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores. There was a significant improvement of liver stiffness after end of treatment, regardless of the DAA regimen used, as evidenced by Fibroscan. Conclusion Fibrosis regression –assessed by non-invasive markers of fibrosis is achievable upon removal of the causative agent.

scholarly journals Liver stiffness in chronic hepatitis C virus infection

2019 ◽  
Vol 57 (2) ◽  
pp. 85-98
Author(s):  
Romeo-Gabriel Mihăilă
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Stiffness Measurement ◽  
A Value

Abstract Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

Prospective Evaluation of Semiquantitative Strain Ratio and Quantitative 2D Ultrasound Shear Wave Elastography (SWE) in Association with TIRADS Classification for Thyroid Nodule Characterization

2019 ◽  
Vol 40 (04) ◽  
pp. 495-503 ◽  
Author(s):  
Vito Cantisani ◽  
Emanuele David ◽  
Hektor Grazhdani ◽  
Antonello Rubini ◽  
Maija Radzina ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Prospective Evaluation ◽  
2D Ultrasound

Abstract Purpose To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. Materials and Methods In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. Results TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. Conclusion Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

scholarly journals On the Impact of Nonalcoholic Fatty Liver Disease, Confirmed by Biopsy, on the Results of the Two-Dimensional Shear Elastography

2017 ◽  
pp. 88-95
Author(s):  
A. N. Katrich ◽  
A. V. Okhotina ◽  
O. N. Ponkina ◽  
N. S. Ryabin
Keyword(s):  
Shear Wave ◽  
Liver Tissue ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Outcome Analysis ◽  
Diagnostic Efficiency ◽  
Nonalcoholic Fatty Liver ◽  
Group 2 ◽  
The Impact

The aim:to study of the effect of NAFLD on the results of shear elastography (based on the results of liver biopsy).  Materials and methods.We have performed outcome analysis in 137 patients, treated from 2015 to 2016. All patients had chronic diffuse liver diseases and were hospitalized for morphological evaluation and diagnosis clarification. Group 1 (n = 117) with no fat changes in the liver parenchyma. Group 2 (n = 20) with steatosis of the liver.  In our work, we used: scanner Aixplorer (France). All patients underwent shear wave elastography (2DSWE) with the study of the quantitative index of stiffness of liver tissue, staging the results on the Metavir scale.Results.In the 1st group of patients (without steatosis), in the ROC analysis, cutoff values of elasticity were obtained, the diagnostic efficiency of the Metavir stage of fibrosis was the most optimal: for F2 > 6.8 kPa (sensitivity 85.7, specificity 52, 9, AUROC 0.684); For F3 > 8.5 kPa (sensitivity 91, specificity 57.1, AUROC 0.745); For F4 > 14 kPa (sensitivity 95.7, specificity 52.2, AUROC 0.791). It was found, that the presence of steatosis significantly increases the elasticity of the liver tissue. So, in the subgroup sF0 (with steatosis) was a significant increasing of young's module Ме = 11,2 kPa (95% CI 7,3–17,5) compared to Ме = 6,1 kPa (95% CI 5,4– 9,6) in the subgroup F0 (without steatosis) (P = 0,0168, AUROC = 0,741) and up to Ме=9,95 kPa (95% CI 6,8–13,0) in the subgroup sF0 + sF1 (with steatosis) compared with Ме=6,65 kPa (95%CI 5,6–9,5) of the subgroup F0 + F1 (without steatosis) (P = 0.0295, = 0.707). This increase was, respectively, 83,6% and 49.6%  Сonclusions.This study confirmed the effectiveness of the shear wave elastography method in assessing the relationship between stiffness parameters and the morphological fibrosis of the liver parenchyma and also contributed to the final confirmation of the effect of steatosis on  liver stiffness.

Noninvasive Assessment of Liver Stiffness in Patients Undergoing the Fontan Procedure

2020 ◽  
Vol 11 (5) ◽  
pp. 572-577 ◽  
Author(s):  
Sachin Talwar ◽  
Vasubabu Gudala ◽  
Raja Joshi ◽  
DM Shalimar ◽  
Kumble Seetharama Madhusudhan ◽  
...  
Keyword(s):  
Liver Injury ◽  
Transient Elastography ◽  
Early Recognition ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Noninvasive Methods ◽  
Over Time

Background: Hepatic derangements and liver injury following the Fontan operation (FO) may progress in some cases to hepatic fibrosis (HF) and cirrhosis. The respective roles of transient elastography (TE) or FibroScan, shear wave elastography (SWE), and aspartate transaminase to platelet ratio index (APRI) in assessing liver stiffness (LS) and possible liver injury in these patients are unclear. Methods: Thirty-nine patients (31 males), mean age 11.8 ± 5.7 years, median 11 years (interquartile range: 7-14.7 years), undergoing the FO between November 2017 and December 2018 were included. Liver stiffness and HF assessment was done with TE, SWE, and APRI in the preoperative period and postoperatively at 3-, 6-, and 12-month interval. Results: The LS values increased over time (postoperative values at 3, 6, and 12 months) as compared to preoperative values by both FibroScan and SWE. The change in liver stiffness measurement (LSM) was statistically significant: LSM0 to LSM3 ( P ≤ .0001), LSM0 to LSM6 ( P ≤ .0001), and LSM0 to LSM12 ( P = .001). Similarly, significant changes were observed on SWE: SWE0 to SWE3 ( P ≤ .0001), SWE0 to SWE6 ( P ≤ .0001), and SWE0 to SWE12 ( P = .001). There was no significant change in the APRI values over time. Conclusion: Noninvasive methods such as FibroScan and SWE may be of use to assess LS in follow-up of patients undergoing the FO for early recognition of hepatic changes.

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