scholarly journals Ultrasound examination of the liver: the search for the most reproducible and easy to operate measuring method of the right lobe oblique craniocaudal diameter

2021 ◽  
Vol 11 (4) ◽  
pp. 68-79
Author(s):  
I. A. Stepanyan ◽  
V. A. Izranov ◽  
V. S. Gordova ◽  
M. A. Beleckaya ◽  
U. B. Palvanova

Introduction. Mismatching of the organ sizes to the standard measurements is the sign of pathology, so it is important to make measurements using the same method for the same type of assessment.Goal: to evaluate the intra- and inter-research reproducibility of the oblique craniocaudal diameter measurement of the right liver lobe with the application of Russian and European methods by different operators, and find out which of the methods is the most convenient for practical application.Materials and methods. 47 healthy volunteers and 3 operators were participated in the study. One of the operators participated in both stages of study.Results. Keeping conditions such as quiet breathing and longitudinal scanning in the anterior axillary line from the VII-X intercostal spaces increases reproducibility and provides well visualization of the lobe even if the patient is not prepared for the study.Conclusion. The oblique size of the right lobe is highly reproducible for both methods, but the European method (longitudinal scanning of right lobe) is more convenient for the practical application. 

Medicina ◽  
2008 ◽  
Vol 44 (9) ◽  
pp. 694
Author(s):  
Saulius Rutkauskas ◽  
Vytautas Gedrimas ◽  
Tomas Čičinskas ◽  
Aurimas Savulis ◽  
Algidas Basevičius

Majority of interventional procedures are made at the porta hepatis, which has a different location on the visceral surface of the liver. Objective. To describe the location of the porta hepatis in respect of the borders of the visceral surface and separate lobes of the liver. Material and methods. Sixty-four human livers were obtained at autopsy (mean age, 45 years). We chose the point of the crossing of longitudinal and transversal lines of the porta hepatis, which was considered as center of the porta hepatis. The distances from the center of the porta hepatis to the border of the visceral surface every 10 degrees with protractor and ruler and the angles of anatomical structures were measured. Additionally, the borders of lobes were assessed. Results. We found that center of the porta hepatis is located approximately 11.6±2.8 cm from the border of the visceral liver surface. The location of center of the porta hepatis was 11.6±1.1 cm from the border of left lobe, 9.7±1.5 cm from the border of quadrate lobe, 12.3±1.2 cm from the border of right lobe, and 7.4±1.0 cm from the border of caudate lobe. All distances were statistically significant (P<0.05). An angle of the fissure for round ligament was 50.5°, of the fossa of gallbladder – 102°, of the groove of vena cava inferior – 266°, and of the fissure for ligamentum venosum – 293°. The borders of the right, left, quadrate, and caudate liver lobe covered 45.6%, 32.6%, 14.3%, and 7.5% of the perimeter of visceral surface border, respectively. Conclusions. The center of the porta hepatis can help to characterize precisely the position of the porta hepatis on the visceral surface of the liver.


Author(s):  
Uiase Bin Farooq ◽  
Adarsh Kumar ◽  
Rajni Chaudhary

The main objective of this study was to develop baseline topographical data of landmarks for locating liver and spleen and to generate sonographic calliper measurements along with dynamic parameters of these organs. Abdominal ultrasonography was performed on 50 native adult (Spiti horses and Himalayan hill mules) healthy unsedated equines of either sex. The thickness, character and echo-architecture of liver and spleen were recorded. In horses, the right lobe of liver was found from 8th to 15th intercostal space (ICS) and left lobe from 6th to 11th (±1) ICS, while in mules the right liver lobe was found between 6th to 15th (±1) ICS and left lobe between 6th to 9th (±1) ICS. The liver was recognized by its branching vasculature and architecture was found relatively homogenous. In addition ventral edges were distinctly sharp. Spleen was found from 8th to 17th ICS both in horses as well as in mules. The splenic parenchyma was homogenously granular in appearance with few blood vessels and most echogenic organ in the abdominal cavity of equines. The only measurement that was reliably obtained was the central thickness or depth of the spleen, which varied from 41.4 to 68.4 mm (Mean± SE= 50.84±4.61 mm) in horses and 37.9 to 51.6 mm (Mean± SE = 42.76±2.34 mm) in mules. Therefore detailed ultrasonographic examination of liver and spleen helped us to compile baseline data, which will be helpful in management of the affections of liver and spleen in future.


2018 ◽  
Vol 46 (6) ◽  
pp. 598-608 ◽  
Author(s):  
S. E. Voskanyan ◽  
A. I. Artemyev ◽  
A. I. Sushkov ◽  
I. Yu. Kolyshev ◽  
V. S. Rudakov ◽  
...  

Rationale: Adult-to-adult right lobe living donor liver transplantation is a  viable alternative to whole liver transplantation from a  deceased donor. The key aspect of the surgical procedure is the restoration of adequate graft blood flow and maintenance of sufficient volume of well vascularized parenchyma in the donor. Specific features of vascular anatomy in the donor and the recipient can be eventual cause for significant technical difficulties during transplantation. They can also increase the risk of complications and deteriorate graft functioning.Aim: To identify the incidence of various types of afferent and efferent vascularization of right lobe of the liver, potential techniques of vascular reconstructive procedures, rates and types of postoperative complications, as well as immediate surgical results.Materials and methods: We retrospectively analyzed the data on 220 right lobe liver transplantations adult patients, consecutively performed from 2010 to 2017 in one center. Specific characteristics of liver vascularization in donors and recipients were determined by pre-operative computed tomography and intra-operatively. The information on the types of vascular reconstruction, complications and results of surgical procedures was obtained from patients' medical files.Results: The following variants of blood supply to the right liver lobe were seen most frequently: portal vein trifurcation 22%, shortened trunk of the right portal vein branch 13%, supplementary v. hepatica from SgVIII with a diameter of > 5 mm 22%, supplementary lower right v. hepatica 17%, isolated venous outflow from all right lobe segments 2%, two arteries 2%. In addition, 17% of the recipients had portal vein thrombosis and 1% portal vein fibrosis. During the follow-up all donors remained alive. The rate of surgical complications was 12.5%, among them bile pocket or biloma 8.5%, intra-abdominal bleeding 2.5%, wound complications 1.5%. The rate of early post-operative complications in the recipients was 31.5%, with 4.5% of them being vascular and 15.5% biliary. The 6-months and 4-years survival of the recipients (Kaplan-Meier) was 98% and 95%, respectively.Conclusion: Immediate and longterm survival of the recipients of living donor right lobe live grafts, as well as absence of fatalities among their donors, confirm high effectiveness and expedience of this type of intervention. The observed anatomic variety of blood supply to the right liver lobe stipulates stringent requirements to the quality of preoperative diagnostics, deliberate donor selection, thorough planning of the procedure and high qualification of the surgical team. A  relatively high rate of postoperative complications warrants the necessity of an intensive diagnostic monitoring in the early post-operative period and active strategies of their correction.


2016 ◽  
Vol 57 (1-2) ◽  
pp. 125-137 ◽  
Author(s):  
Weiwei Wei ◽  
Tianjiao Zhang ◽  
Haoshu Fang ◽  
Olaf Dirsch ◽  
Andrea Schenk ◽  
...  

Background/Aim: Liver size regulation is based on the balance between hepatic regeneration and atrophy. To achieve a better understanding of intrahepatic size regulation, we explored the size regulation of a portally deprived liver lobe on a liver subjected to concurrent portal vein ligation (PVL) and partial hepatectomy (PHx). Materials and Methods: Using a surgical rat model consisting of right PVL (rPVL) plus 70% PHx, we evaluated the size regulation of liver lobes 1, 2, 3, and 7 days after the operation in terms of liver weight and hepatocyte proliferation. Portal hyperperfusion was confirmed by measuring portal flow. The portal vascular tree was visualized by injection of a contrast agent followed by CT imaging of explanted livers. Control groups consisted of 70% PHx, rPVL, and sham operation. Results: The size of the ligated right lobe increased to 1.4-fold on postoperative day 7 when subjected to rPVL + 70% PHx. The right lobe increased to 3-fold when subjected to 70% PHx alone and decreased to 0.3-fold when subjected to rPVL only. The small but significant increase in liver weight after the combined procedure was accompanied by a low proliferative response. In contrast, hepatocyte proliferation was undetectable in the right lobe undergoing atrophy after PVL only. The caudate lobe in the rPVL + 70% PHx group increased to 4.6-fold, which is significantly more than in the other groups. This increase in liver weight was paralleled by persisting portal hyperperfusion and a prolonged proliferative phase of 3 days. Conclusions: A discontinued portal blood supply does not always result in atrophy of the ligated lobe. The concurrent regenerative stimulus induced by 70% PHx seemed to counteract the local atrophy after a simultaneously performed rPVL, leading to a low but prolonged regenerative response of the portally deprived liver lobe. This observation supports the conclusion that portal flow is not necessary for liver regeneration. The persisting portal hyperperfusion may be crucial for the specific kinetics of prolonged liver regeneration after rPVL + 70% PHx in the portally supplied caudate lobe. Both observations deserve more attention regarding the underlying mechanism in further studies.


2001 ◽  
Vol 120 (5) ◽  
pp. A261-A261
Author(s):  
F CETTA ◽  
M ZUCKERMANN ◽  
G ERCOLANI ◽  
G MONTALTO ◽  
M GORI ◽  
...  

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Achmad R. Permadi ◽  
Hana Ratnawati ◽  
Teresa L. Wargasetia

Liver cancer is the fifth most common cancer in Indonesia. This research is to find out the prevalence and characteristics of liver cancer patients in Immanuel Hospital Bandung within the January 2013 until December 2014 period based on age, gender, clinical symptoms and predilections. This study was a descriptive verificative research with data retrieval of patients medical records that have been diagnosed with liver cancer that were hospitalized in Immanuel Hospital Bandung within January 2013 until December 2014 period. The study showed that the liver cancer patient prevalence in Immanuel Hospital Bandung within the period of January 2013 until December 2014 was 46 people. Characteristics of liver cancer patients in Immanuel Hospital Bandung within January 2013 until December 2014 period showed that the most liver cancer patients were male, compare with female with ratio 4:1, the most common age group of 56-65 years old, the most common clinical symptoms were abdominal pain with or without reffered pain to the right scapular bone and the most common predilection was right lobe of the liver. Key words: liver cancer, patients' characteristics, prevalence 


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Parviz Mardani ◽  
Ali Talebi Ezabadi ◽  
Bahareh Sedaghat ◽  
Seyed Mahmoud Sadjjadi

Abstract Background Cystic echinococcosis (CE)/hydatidosis is an important neglected parasitic zoonotic disease caused by the metacestode of Echinococcus granulosus s.l. The present study was designed to identify the pulmonary CE species/genotypes in isolated human underwent to surgery in our center in Southern Iran. Methods The study population of this study were all patients in Fars province who were admitted to Namazi Hospitals for pulmonary hydatid cyst surgery. Thoracic surgery was performed in the thoracic ward and the cyst/s was removed by open surgery via posterolateral or lateral thoracotomy. DNA was extracted from the germinal layer or the protoscoleces. PCR technique was performed using the cytochrome C oxidase subunit1 (cox1) gene, and the products were sequenced. Results A total of 32 pulmonary hydatid cyst samples were collected from 9 (28%) female and 23 (72%) male aged from 4 to 74 years old. A total of 18(56%) cyst/s were in the left lobe and 14 (44%) cysts in the right lobe. Sequence analysis of the cysts showed that 24 samples (75%) were E. granulosus s.s (G1-G3) genotype and 8 (25%) were E. canadensis (G6/G7) genotype. Conclusion E.granulosus s.s genotype was the most prevalent genotype followed by E. canadensis (G6/G7) genotype. There was no significant statistical correlation between cysts’ size, location, genotype strain, and patients’ age and gender.


Author(s):  
Kotaro Matsumoto ◽  
Kentaro Kikuchi ◽  
Ayako Hara ◽  
Hiromichi Tsunashima ◽  
Koichi Tsuneyama ◽  
...  

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.


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