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The Cutoff Values of ARFI Two-Location Measurement in Different Metavir Fibrosis Scores and Etiologies
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Ultrasound in Medicine and Biology
p, .01). The SWV of the SCM was significantly higher in group 1S than in group 1M. In group 1, the SWV of the affected SCM was positively correlated with the degree of deficits in PROM of neck rotation in the affected side (r 5 .77; p , .01). Conclusions: This study revealed a difference in the SWV of the affected SCM according to the limitation of neck rotation PROM in infants with CMT and SCM thickness greater than 10 mm, although no difference in SCM thickness was observed. PPT7-016 Sonoelastographic Findings in De Quervain’s Disease Shih-Hao Cheng,1 Jyun-Yan Liou2 1 Department of Orthopaedic Surgery, Penghu Hospital, Ministry of Health and Welfare, Taiwan, 2Department of Radiology, Penghu Hospital, Ministry of Health and Welfare Objectives: De Quervain’s disease is a common condition involved the first extensor compartment of the wrist. The inflammatory process often affects tendons and causes degeneration. In the study, we aim to use sonoelastography to compare the tendon integrity between patients and healthy volunteers. Methods: A total of 20 healthy volunteers and 20 patients with De Quervain’s disease diagnosed by clinical symptoms and physical examinations were enrolled into the study. All patient received bilateral wrists sonography, including conventional B-mode sonography and elastography. The tendon was divided into three group: grade 1: blue (hardest) to green (hard); grade 2: yellow (soft); and grade 3: red (softest). We also use strain ratio between tendon and subcutaneous fat tissue for quantitative comparisons. Results: In the symptomatic groups, there are higher rate of intratendinous hypoechogenicity and peritendon effusion. Elastography also showed higher proportion of grade 2 and grade 3 tendinopathy. The strain ratio of the tendon was also significantly lower than healthy group, indicating softer texture. Conclusions: The study showed patients with De Quervain’s disease had significantly lower strain ratio in their tendon within first extensor compartment across the radial styloid. Ultrasound elastography could be a promising method to evaluate such tendon abnormalities. PPT7-017 Spleen Stiffness Evaluated by Acoustic Radiation Force Impulse (ARFI) Elastography in Cirrhotic Patients is not a Useful Tool to Predict Esophageal Varices Needing Treatment Giovanni Galati, Antonio De Vincentis, Alessandro Guidi, Paolo Gallo, Umberto Vespasiani, Antonio Picardi Department of Hepatology, University Campus Bio Medico, Italy Objectives: BackgroundThe spleen stiffness (SS) and liver stiffness (LS), evaluated by Acoustic Radiation Forced Impulse (ARFI), have been related to the risk of varices needing treatment (VNT) in compensated cirrhotic patients. AimAim of our study was to test the diagnostic value of SS in predicting the presence of VNT in a consecutive population of cirrhotic patients. Methods: We studied two groups: the non-cirrhotic group (NCG) in which histology or clinical features ruled out a liver cirrhosis; the cirrhotic group (CG) of historical patients followed by the Ultrasound Service of our Liver Unit. We studied two groups: the non-cirrhotic group (NCG); the cirrhotic group (CG) of historical patients followed by the Ultrasound Service of our Liver Unit. Over a total consecutive period of four months, all included patients underwent liver and spleen ARFI examination.
Volume 43, Number S1, 2017 Results: We enrolled 145 patients. The first group was of 41 noncirrhotic patients (24 biopsy-proven: 2 Fibrosis 0/6, 6 Fibrosis 1/6, 5 fibrosis 2/6, 9 Fibrosis 3/6, 2 Fibrosis 4/6 sec. Ishak); the second group of 104 cirrhotic patients (all clinically diagnosed). LS and Spleen Diameter (SD) were significantly lower in the NCG, otherwise the platelets (PLTs), the PLTs/SD ratio and transaminases were significantly higher in the NCG than CG (p, 0.001). SS was not significantly different in NCG and CG, neither in presence of VNT (p50.161). In the multivariate analysis, LS [adjusted-OR 2.4 (1.17-5.34)], platelets [adjusted-OR 0.98 (0.97-0.99)] and spleen diameter [adjusted-OR 1.16 (0.96-1.36)] were associated with presence of VNT in CG, but SS was not. Conclusions: ConclusionsWe suggest that SS is not a useful tool to detect VNT among cirrhotic patients. The explanation could lie in the higher stiffness of the spleen in respect to the liver, independently of liver fibrosis and not influenced by portal hypertension. PPT7-018 The Cutoff Values of ARFI Two-Location Measurement in Different Metavir Fibrosis Scores and Etiologies Dar-In Tai,1 Tse-Hwa Hsu,1 Po-Hsiang Tsui,2 Wan-Ting Yu,1 Shiu-Feng Huang,3 Yung-Liang Wan2 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taiwan, 2Department of Medical imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, 3Division of Molecular and Genomic Medicine, National Health Research Institute Objectives: Assessment of liver fibrosis with acoustic radiation force impulse (AFRI) imaging is a popular modality to measure liver fibrosis. ARFI may select an optimal location for measurement under imaging guiding. However, there are some debates on standardized protocol for ARFI in compared with well-established protocol in Fibroscan. To decrease the variation of ARFI, we developed two-location measurement with standardized protocol. We would like to establish the cutoff values according to Metavir fibrosis score in different etiologies. Methods: A consecutive series of patients who received liver histology study were prospectively enrolled. All cases had hemogram, liver biochemistry, viral markers and ARFI two-location measurement within 4 weeks of histology study. A standardized protocol was used and carried out by a single technologist. Results: A total of 457 patients that included 84 negative for both HBsAg and anti-HCV (NBNC), 20 autoimmune liver diseases, 283 chronic hepatitis B (CHB) and 70 hepatitis C (CHC) were enrolled. Among patients in NBNC, 64 with fat cell .10% and non-alcoholism are considered as non-alcoholic fatty liver disease (NAFLD). The AUROC for Metavir 4 fibrosis were 0.949, 0.766 and 0.939 for NAFLD, CHB and CHC, respectively. The cutoff values for Metavir F4 were 1.750, 1.505 and 1.750 for NAFLD, CHB and CHC, respectively. The sensitivity and specificity were satisfactory and both were over 0.8 for patients with NAFLD and CHC, but was between 0.718 and 0.741 in CHB. Conclusions: The diagnostic performance of two-location measurement is accurate for NAFLD and CHC, but is relatively poor in CHB. PPT7-019 The Value of 2D-Swe.Ge for the Evaluation of Liver Fibrosis in Patients with HCV Compensated Chronic Hepatopathies Ioan Sporea,1 Felix Bende,2 Alina Popescu,1 Roxana Sirli,1 Mirela Danila,1 Ruxandra Mare,1 Ana Maria Stepan1 1 Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, Romania,
Ultrasound in Medicine and Biology
p, .01). The SWV of the SCM was significantly higher in group 1S than in group 1M. In group 1, the SWV of the affected SCM was positively correlated with the degree of deficits in PROM of neck rotation in the affected side (r 5 .77; p , .01). Conclusions: This study revealed a difference in the SWV of the affected SCM according to the limitation of neck rotation PROM in infants with CMT and SCM thickness greater than 10 mm, although no difference in SCM thickness was observed. PPT7-016 Sonoelastographic Findings in De Quervain’s Disease Shih-Hao Cheng,1 Jyun-Yan Liou2 1 Department of Orthopaedic Surgery, Penghu Hospital, Ministry of Health and Welfare, Taiwan, 2Department of Radiology, Penghu Hospital, Ministry of Health and Welfare Objectives: De Quervain’s disease is a common condition involved the first extensor compartment of the wrist. The inflammatory process often affects tendons and causes degeneration. In the study, we aim to use sonoelastography to compare the tendon integrity between patients and healthy volunteers. Methods: A total of 20 healthy volunteers and 20 patients with De Quervain’s disease diagnosed by clinical symptoms and physical examinations were enrolled into the study. All patient received bilateral wrists sonography, including conventional B-mode sonography and elastography. The tendon was divided into three group: grade 1: blue (hardest) to green (hard); grade 2: yellow (soft); and grade 3: red (softest). We also use strain ratio between tendon and subcutaneous fat tissue for quantitative comparisons. Results: In the symptomatic groups, there are higher rate of intratendinous hypoechogenicity and peritendon effusion. Elastography also showed higher proportion of grade 2 and grade 3 tendinopathy. The strain ratio of the tendon was also significantly lower than healthy group, indicating softer texture. Conclusions: The study showed patients with De Quervain’s disease had significantly lower strain ratio in their tendon within first extensor compartment across the radial styloid. Ultrasound elastography could be a promising method to evaluate such tendon abnormalities. PPT7-017 Spleen Stiffness Evaluated by Acoustic Radiation Force Impulse (ARFI) Elastography in Cirrhotic Patients is not a Useful Tool to Predict Esophageal Varices Needing Treatment Giovanni Galati, Antonio De Vincentis, Alessandro Guidi, Paolo Gallo, Umberto Vespasiani, Antonio Picardi Department of Hepatology, University Campus Bio Medico, Italy Objectives: BackgroundThe spleen stiffness (SS) and liver stiffness (LS), evaluated by Acoustic Radiation Forced Impulse (ARFI), have been related to the risk of varices needing treatment (VNT) in compensated cirrhotic patients. AimAim of our study was to test the diagnostic value of SS in predicting the presence of VNT in a consecutive population of cirrhotic patients. Methods: We studied two groups: the non-cirrhotic group (NCG) in which histology or clinical features ruled out a liver cirrhosis; the cirrhotic group (CG) of historical patients followed by the Ultrasound Service of our Liver Unit. We studied two groups: the non-cirrhotic group (NCG); the cirrhotic group (CG) of historical patients followed by the Ultrasound Service of our Liver Unit. Over a total consecutive period of four months, all included patients underwent liver and spleen ARFI examination.
Volume 43, Number S1, 2017 Results: We enrolled 145 patients. The first group was of 41 noncirrhotic patients (24 biopsy-proven: 2 Fibrosis 0/6, 6 Fibrosis 1/6, 5 fibrosis 2/6, 9 Fibrosis 3/6, 2 Fibrosis 4/6 sec. Ishak); the second group of 104 cirrhotic patients (all clinically diagnosed). LS and Spleen Diameter (SD) were significantly lower in the NCG, otherwise the platelets (PLTs), the PLTs/SD ratio and transaminases were significantly higher in the NCG than CG (p, 0.001). SS was not significantly different in NCG and CG, neither in presence of VNT (p50.161). In the multivariate analysis, LS [adjusted-OR 2.4 (1.17-5.34)], platelets [adjusted-OR 0.98 (0.97-0.99)] and spleen diameter [adjusted-OR 1.16 (0.96-1.36)] were associated with presence of VNT in CG, but SS was not. Conclusions: ConclusionsWe suggest that SS is not a useful tool to detect VNT among cirrhotic patients. The explanation could lie in the higher stiffness of the spleen in respect to the liver, independently of liver fibrosis and not influenced by portal hypertension. PPT7-018 The Cutoff Values of ARFI Two-Location Measurement in Different Metavir Fibrosis Scores and Etiologies Dar-In Tai,1 Tse-Hwa Hsu,1 Po-Hsiang Tsui,2 Wan-Ting Yu,1 Shiu-Feng Huang,3 Yung-Liang Wan2 1 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taiwan, 2Department of Medical imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, 3Division of Molecular and Genomic Medicine, National Health Research Institute Objectives: Assessment of liver fibrosis with acoustic radiation force impulse (AFRI) imaging is a popular modality to measure liver fibrosis. ARFI may select an optimal location for measurement under imaging guiding. However, there are some debates on standardized protocol for ARFI in compared with well-established protocol in Fibroscan. To decrease the variation of ARFI, we developed two-location measurement with standardized protocol. We would like to establish the cutoff values according to Metavir fibrosis score in different etiologies. Methods: A consecutive series of patients who received liver histology study were prospectively enrolled. All cases had hemogram, liver biochemistry, viral markers and ARFI two-location measurement within 4 weeks of histology study. A standardized protocol was used and carried out by a single technologist. Results: A total of 457 patients that included 84 negative for both HBsAg and anti-HCV (NBNC), 20 autoimmune liver diseases, 283 chronic hepatitis B (CHB) and 70 hepatitis C (CHC) were enrolled. Among patients in NBNC, 64 with fat cell .10% and non-alcoholism are considered as non-alcoholic fatty liver disease (NAFLD). The AUROC for Metavir 4 fibrosis were 0.949, 0.766 and 0.939 for NAFLD, CHB and CHC, respectively. The cutoff values for Metavir F4 were 1.750, 1.505 and 1.750 for NAFLD, CHB and CHC, respectively. The sensitivity and specificity were satisfactory and both were over 0.8 for patients with NAFLD and CHC, but was between 0.718 and 0.741 in CHB. Conclusions: The diagnostic performance of two-location measurement is accurate for NAFLD and CHC, but is relatively poor in CHB. PPT7-019 The Value of 2D-Swe.Ge for the Evaluation of Liver Fibrosis in Patients with HCV Compensated Chronic Hepatopathies Ioan Sporea,1 Felix Bende,2 Alina Popescu,1 Roxana Sirli,1 Mirela Danila,1 Ruxandra Mare,1 Ana Maria Stepan1 1 Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, Romania,