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Comparison between the performance of Two-Dimensional and Point Shear Wave elastography for the noninvasive assessment of liver cirrhosis
Abstracts Keywords: liver fibrosis, Transient Elastography, feasibility. Reference: 1. Tsochatzis EA, Gurusamy KS, Ntaoula S, Cholongitas E, Davidson BR, Burroughs AK. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a metaanalysis of diagnostic accuracy. J Hepatol 2011;54:650- 659. Changes in medial temporal lobe in Alzheimers disease detected using transcranial sonography David Skoloudik,1,2 Petra Krulova,1,2 Helena Kisvetrova,2 Jiri Blahuta,2,3 Tomas Soukup2,3 1 Department of Neurology, Comprehensive Stroke Center, University Hospital Ostrava, Ostrava, Czechia, Czech Republic, 2 Center for Science and Research, Faculty of Health Sciences, Palack y University Olomouc, Olomouc, Czechia, Czech Republic, 3 Institute of Computer Science, Silesian University Opava, Opava, Czechia, Czech Republic Background: Atrophy of the medial temporal lobe is one of the anatomical hallmarks of Alzheimer’s disease (AD). Transcranial sonography (TCS) is able to visualize and measure the MTL. Purpose: Study aims to test digital image analysis of MTL image in AD compared to healthy controls. Methods: Patients with AD and healthy controls underwent TCS. The medial temporal lobe and the surrounding space was imaged in the coronal plane on TCS from both sides. All images were encoded and evaluated using B-Mode Assist software with counting the black/white ratio of the medial temporal lobe. The ROC curve, optimal cut-off value, sensitivity, specificity, positive and negative predictive values were statistically evaluated. Results: Totally 78 subjects were enrolled to the study during 6 months; 31 AD patients (14 males, 76.2 § 5.8 years) and 47 healthy controls (21 males, 75.5 § 6.4 years). Significantly lower black/white ratio was found in AD patients compared with healthy controls (1.63 § 0.75 vs 3.43 § 1.01; P ˂ 0.001). The optimal cut-off value for differentiation between AD and healthy controls was 2.5 with a sensitivity 90.3%, a specificity 87.2%, a positive predictive value 82.3% and a negative predictive value 93.2%. Conclusion: Digital image analysis of the TCS medial temporal lobe images enables to measure black/white ratio as a marker of MTL atrophy in AD patients. Study was supported by grant of Ministry of Health of the Czech Republic No. 16-28628A.
Diastematomyelia- a rare ultrasound diagnosis of spinal dysraphism Debbie Slade Introduction: Diastematomyelia is a rare congenital anomaly where there is complete or partial duplication of the spinal cord as a result of a fibrous, cartilaginous or osseous spur. By 1994 only 100 cases had been reported worldwide. Diagnosis, if prenatal, is usually late 3rd trimester. This poster depicts a case study illustrating ultrasound appearances at 17 weeks gestation and prenatal diagnosis of Diastematomyelia at 24 weeks describing Epidemiology, Presentation, Associated Anomalies, Ultrasound appearances, Treatment and Prognosis. Rationale: Due to the infrequent presentation and low recorded incidence of Diastematomyelia, limited literature is available on this condition. The purpose of this poster is to rectify this dilemma. Objectives: 1. To raise awareness of the sonographic appearance of the extremely rare Diastematomyelia. 2. To disseminate the importance of an early diagnosis to promote ‘Best Practice Care’ and better patient outcomes.
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3. To encourage sonographers to be vigilant and ensure thorough scanning. Method: -A thorough obstetric ultrasound examination concentrating on morphology was performed utilising a Toshiba Aplio unit and 10 MHZ and 3.5MHZ curved array transducers. -Maternal and fetal structures were interrogated and documented paying particular attention to the transverse, longitudinal and coronal images of the fetal spine, skin-line and fetal cranium when a spinal abnormality was suspected. -Ultrasound appearances were compared with normal anatomy. Results: Identification of an additional spinal cord posterior ossification centre is pathognomic for ultrasound antenatal diagnosis of Diastematomyelia. Conclusions: The resultant significance of this poster research is to promote earlier diagnosis of this fetal anomaly and associated abnormalities assisting parents with informed decisions concerning obstetric care if their baby is affected by Diastematomyelia.
Comparison between the performance of Two-Dimensional and Point Shear Wave elastography for the noninvasive assessment of liver cirrhosis Victor B^ aldea, Raluca Lupușoru, Mirela D anil a, Roxana Șirli, Alina Popescu, Ioan Sporea Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania Background and aim: The goals of this study were to compare the noninvasive diagnostic performance of two elastography techniques for the diagnosis of liver cirrhosis in a cohort of patients with known hepatitis C virus using Transient Elastography FibroScan as the method of reference since it is a validated tool for the non-invasive assessment of liver fibrosis. Material and Methods: The study included 122 patients aged 38-80 (62 § 7.9), 35% male (43/122), 65% female (79/122) with known hepatitis C virus in whom liver stiffness was evaluated during the same session by means of three elastography Methods: Point Shear Wave Elastography (pSWE) using virtual touch quantification(VTQ) technology Siemens Acuson S2000TM, Two-Dimensional Shear Wave Elastography (2D-SWE) embedded in General Electrics LOGIQ E9 ultrasound machine and Transient Elastography(TE;FibroScan, EchoSens). Reliable LS measurements were defined, for all techniques, as the median value of 10 measurements with an interquartile range/median (IQR/MED) < 30%. For diagnosing liver cirrhosis the TE cut-off value of 12.5 kPa was used(1).The areas under receiver operating characteristic curve(AUROC) were used to assess the diagnostic performance of VTQ and 2D-SWE.GE and comparisons were made between both methods using TE as reference. Results: Reliable liver stiffness measurements were obtained in 93% (114/122) of cases by means of TE, 88% (107/122) of cases by means of VTQ and 87% (106/122) of cases by means of 2D-SWE.GE. In the final analysis we included 93 patients which had reliable stiffness measurements with all methods.The AUROCS were calculated considering TE as the reference method. The optimal cutoff of VTQ for cirrhosis was 1.77m/s(SE:83%; SP:88%; AUC:0.89) and for 2D-SWE.GE was 10.2 kPa(SE:86%; SP:77%; AUC:0.89). No statistical differences were found between both methods(p < 0.96). Conclusion: Both methods have similar performance for diagnosing liver cirrhosis and seem to be a promising alternative to Transient Elastography in evaluating patients with liver fibrosis. Reference: 1. Castera, L., Forns, X. and Alberti, A. (2008). Non-invasive evaluation of liver fibrosis using transient elastography. Journal of Hepatology, 48(5), pp.835-847.
Diastematomyelia- a rare ultrasound diagnosis of spinal dysraphism Debbie Slade Introduction: Diastematomyelia is a rare congenital anomaly where there is complete or partial duplication of the spinal cord as a result of a fibrous, cartilaginous or osseous spur. By 1994 only 100 cases had been reported worldwide. Diagnosis, if prenatal, is usually late 3rd trimester. This poster depicts a case study illustrating ultrasound appearances at 17 weeks gestation and prenatal diagnosis of Diastematomyelia at 24 weeks describing Epidemiology, Presentation, Associated Anomalies, Ultrasound appearances, Treatment and Prognosis. Rationale: Due to the infrequent presentation and low recorded incidence of Diastematomyelia, limited literature is available on this condition. The purpose of this poster is to rectify this dilemma. Objectives: 1. To raise awareness of the sonographic appearance of the extremely rare Diastematomyelia. 2. To disseminate the importance of an early diagnosis to promote ‘Best Practice Care’ and better patient outcomes.
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3. To encourage sonographers to be vigilant and ensure thorough scanning. Method: -A thorough obstetric ultrasound examination concentrating on morphology was performed utilising a Toshiba Aplio unit and 10 MHZ and 3.5MHZ curved array transducers. -Maternal and fetal structures were interrogated and documented paying particular attention to the transverse, longitudinal and coronal images of the fetal spine, skin-line and fetal cranium when a spinal abnormality was suspected. -Ultrasound appearances were compared with normal anatomy. Results: Identification of an additional spinal cord posterior ossification centre is pathognomic for ultrasound antenatal diagnosis of Diastematomyelia. Conclusions: The resultant significance of this poster research is to promote earlier diagnosis of this fetal anomaly and associated abnormalities assisting parents with informed decisions concerning obstetric care if their baby is affected by Diastematomyelia.
Comparison between the performance of Two-Dimensional and Point Shear Wave elastography for the noninvasive assessment of liver cirrhosis Victor B^ aldea, Raluca Lupușoru, Mirela D anil a, Roxana Șirli, Alina Popescu, Ioan Sporea Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania Background and aim: The goals of this study were to compare the noninvasive diagnostic performance of two elastography techniques for the diagnosis of liver cirrhosis in a cohort of patients with known hepatitis C virus using Transient Elastography FibroScan as the method of reference since it is a validated tool for the non-invasive assessment of liver fibrosis. Material and Methods: The study included 122 patients aged 38-80 (62 § 7.9), 35% male (43/122), 65% female (79/122) with known hepatitis C virus in whom liver stiffness was evaluated during the same session by means of three elastography Methods: Point Shear Wave Elastography (pSWE) using virtual touch quantification(VTQ) technology Siemens Acuson S2000TM, Two-Dimensional Shear Wave Elastography (2D-SWE) embedded in General Electrics LOGIQ E9 ultrasound machine and Transient Elastography(TE;FibroScan, EchoSens). Reliable LS measurements were defined, for all techniques, as the median value of 10 measurements with an interquartile range/median (IQR/MED) < 30%. For diagnosing liver cirrhosis the TE cut-off value of 12.5 kPa was used(1).The areas under receiver operating characteristic curve(AUROC) were used to assess the diagnostic performance of VTQ and 2D-SWE.GE and comparisons were made between both methods using TE as reference. Results: Reliable liver stiffness measurements were obtained in 93% (114/122) of cases by means of TE, 88% (107/122) of cases by means of VTQ and 87% (106/122) of cases by means of 2D-SWE.GE. In the final analysis we included 93 patients which had reliable stiffness measurements with all methods.The AUROCS were calculated considering TE as the reference method. The optimal cutoff of VTQ for cirrhosis was 1.77m/s(SE:83%; SP:88%; AUC:0.89) and for 2D-SWE.GE was 10.2 kPa(SE:86%; SP:77%; AUC:0.89). No statistical differences were found between both methods(p < 0.96). Conclusion: Both methods have similar performance for diagnosing liver cirrhosis and seem to be a promising alternative to Transient Elastography in evaluating patients with liver fibrosis. Reference: 1. Castera, L., Forns, X. and Alberti, A. (2008). Non-invasive evaluation of liver fibrosis using transient elastography. Journal of Hepatology, 48(5), pp.835-847.