Shear wave velocity using ARFI is unreliable for detection of cirrhosis in patients with acute stage inflammation

Congress:

ECR 2013

Poster Number:

C-0960

Type:

Scientific Exhibit

Keywords:

Abdomen, Liver, Ultrasound, Diagnostic procedure, Inflammation, Oedema

Authors:

H. J. Kwon¹, J. H. Cho², J. Y. Oh², K. J. NAM², E.-J. Kang²; ¹Pusan/KR, ²Busan/KR

DOI:

10.1594/ecr2013/C-0960

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-0960

Fig. 1: Acoustic radiation force impulse elastography using RFA

Fig. 2: Method: 1.Right lobe of liver through an intercostal space 2.Decubitus...

Fig. 3: Histopatholgic feature in acute hepatitis with underlying chronic...

Fig. 4: Metavir Scoring system using ARFI by summary of pubulished reports

Fig. 5: The change of value in SWV and biochemical marker

Fig. 6: In CT, liver shows nodular aspect in liver surface with quadrate lobe...

Fig. 7: The change of value in SWV and biochemical marker

Fig. 8: The liver shows not any sign of cirrhosis.

Purpose

ARFI(acoustic radiation force impulse) is a new technology that insonates tissues with an acoustic push pulse and detects the degree of deformation of tissue, thereby enabling real-time measurement of liver stiffness. The advantage of ARFI technology over transient elastography is that measurements can be performed with software integrated into a conventional ultrasound examination. Moreover, ARFI can be done in patinets with ascites, such as in this case, because the region of interest can be set under real time ultrasound guidance, which is not possible with...

Methods and Materials

1. Patients The subjects were drawn from a consecutive series of 64 ptients who underwent ARFI because of hepatitis by viral, alchol, autoimmune at our institution with serial follow up after 3~9 months studied between August 2011 and November 2012. All patients had underlying chronic hepatitis including liver cirrhosis. Of the 64 patinets (21 women, 43 men, mean age:53.2 years), 49 patients had viral hepatitis (hepatitis B and or C), and 15 patients had non-viralcause. 2.Ultrasound image acqusition B-mode ultrasound and Real-time elastographyon an Acuson...

Results

1. Subject characteristics. Group of decreased Metavir score was 20 patients (14 men, 6 women ; mean age, 51.3 years ; range, 27 to 70 years). Of the 20 patients, 7 patients had liver cirrhosis and 13 patients had non-liver cirrhosis. Group of no changed or increased Metavir score was 44 patients (29 men, 15 women ; mean age, 54.1 years ; range, 21 to 76 years). Of the 44 patients, 27 patients had liver cirrhosis and 17 patients had non-liver cirrhosis. Table 1. Clinical...

Conclusion

Several previous reports usingtranseint elastographyhave revealed that the degree of liver stiffness increased transiently during the acute phase of acute hepaitits. Acoustic radiation force impulse imaging is a new reproducible techniques for quantative assessment of tissue stiffness through measurement of shear wave velocity, and it has been applied to the evaluation of the extent of fibrosis in chronic liver disease. The changes in SWV value examinations demonstrated in this study suggest the possibility that the SWV value reflects the severity of liver tissue damage in...

References

[1] Sporea I, Şirli R, Popescu A, Danilă M. Acoustic Radiation Force Impulse (ARFI) – a new modality for the evaluation of liver fibrosis. Medical Ultrasonography 2010:12:26 –31 [2] Goyal N, Jain N, Rachapalli V, Cochlin DL, Robinson M. Non-invasive evaluation of liver cirrhosis using Ultrasound. Clinical Radiology 2009:64:1056–66 [3] Gallotti A, D’Onofrio M, Romanini L, CantisaniV, PozziMucelli R. Acoustic Radiation Force Impulse (ARFI) ultrasound imaging of solid focal liver lesions. EurJ Radiol 2011, doi:10.1016/j.ejrad.2010.12.071[4] Cho SH, Lee JY, Kim SH, Lee JM, Han JK,...

Personal Information

1, H. J. Kwon1 Assistant. Prof, Department of radiology, Dong-A univerisity hospital, Seu-gu, dongdaesindong 3ga, Pusan, Korea. 2. J. H. Cho Assoc. Prof, Department of radiology, Dong-A univerisity hospital, Seu-gu, dongdaesindong 3ga, Pusan, Korea. 3.J. Y. Oh Assoc. Prof, Department of radiology, Dong-A univerisity hospital, Seu-gu, dongdaesindong 3ga, Pusan, Korea. 4.K. J. NAM Prof, Department of radiology, Dong-A univerisity hospital, Seu-gu, dongdaesindong 3ga, Pusan, Korea. 5.E.-J. Kang Assistant. Prof, Department of radiology, Dong-A univerisity hospital, Seu-gu, dongdaesindong 3ga, Pusan, Korea.