scholarly journals Evaluation of the change in liver stiffness after biliary drainage in patients with extrahepatic cholestasis

2021 ◽  
Vol 38 (3) ◽  
pp. 260-265
Author(s):  
Fatih UZUNKAYA ◽  
Ayşegül İDİL SOYLU ◽  
İbrahim GÖREN ◽  
Ahmet Veysel POLAT ◽  
Ahmet BEKTAŞ
Keyword(s):  
Biliary Drainage ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Original Design ◽  
Extrahepatic Cholestasis ◽  
Percutaneous Biliary Drainage ◽  
Time Period ◽  
Arfi Elastography

Increased liver stiffness (LS) due to extrahepatic cholestasis has been reported to reduce after biliary drainage. As far as we know, it has not been evaluated whether the method of drainage makes a difference in the change in liver stiffness until now. The aim of the study was to answer this question. The patients planned for endoscopic biliary drainage (EBD) or percutaneous biliary drainage (PBD) were enrolled for over an 18-months’ time period. In those without chronic liver disease or liver tumor, liver stiffness was measured before and 10 days after the intervention, using acoustic radiation force impulse (ARFI) elastography. A total of 30 patients were included in the study excluding the ones not fulfilling the criteria and were divided into two groups: EBD group (n = 15) and PBD group (n = 15). The measurements were above the cut-off value for severe fibrosis (1.55 m/s) in all patients with a mean of 2.50 ± 0.72 m/s before drainage. The pre-drainage values of the PBD group were significantly higher than of the EBD group (2.79 ± 0.58 m/s vs 2.22 ± 0.74 m/s, p = 0.02). In all patients except 11, a significant reduction was observed in the stiffness values. The reduction with PBD was more significant than with EBD (p = 0.04). Percutaneous biliary drainage provided a more significant reduction in liver stiffness in patients with extrahepatic cholestasis. However, this result appears to be related to the nature of obstruction rather than the method of drainage, making the comparison weaker than expected from the original design.

Noninvasive Liver Assessment in Adult Patients With Fontan Circulation Using Acoustic Radiation Force Impulse Elastography and Hepatic Magnetic Resonance Imaging

2017 ◽  
Vol 9 (1) ◽  
pp. 22-30 ◽  
Author(s):  
F. Buendía-Fuentes ◽  
J. L. Melero-Ferrer ◽  
D. Plaza-López ◽  
J. Rueda-Soriano ◽  
A. Osa-Saez ◽  
...  
Keyword(s):  
Liver Disease ◽  
Acoustic Radiation ◽  
Multimodality Imaging ◽  
Fontan Procedure ◽  
Liver Stiffness ◽  
Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Resonance Imaging ◽  
Arfi Elastography ◽  
Fontan Patients

Background: Patients who have undergone the Fontan procedure are at risk of developing hepatic dysfunction. However, broad recommendations regarding liver monitoring are limited. The purpose of this study was to characterize the frequency of liver disease in adult Fontan patients using multimodality imaging (hepatic magnetic resonance imaging [MRI], acoustic radiation force impulse [ARFI] elastography, or hepatic ultrasound). Methods: In a prospective cross-sectional analysis of adult patients palliated with a Fontan procedure, hepatic MRI, ARFI, and hepatic ultrasound were used to assess for liver disease. The protocol compared (1) varying prevalence of liver disease based on each imaging technique, (2) agreement between different techniques, and (3) association between noninvasive imaging diagnosis of liver disease and clinical variables, including specific liver disease biomarkers. Results: Thirty-seven patients were enrolled. The ARFI results showed high wave propagation velocity in 35 patients (94.6%). All patients had some abnormality in the hepatic MRI. Specifically, 8 patients (21.6%) showed signs of chronic liver disease, 10 patients (27%) had significant liver fibrosis, and 27 patients (73%) had congestion. No correlation was found between liver stiffness measured as propagation velocity and hepatic MRI findings. Only 7 patients had an abnormal hepatic ultrasound study. Conclusions: There is an inherent liver injury in adult Fontan patients. Signs of liver disease were observed in most patients by both hepatic MRI and ARFI elastography but not by ultrasound imaging. Increased liver stiffness did not identify specific disease patterns from MRI, supporting the need for multimodality imaging to characterize liver disease in Fontan patients.

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