- Email: [email protected]
The prevalence of liver fibrosis stages assessed by Transient Elastography: a single center study
S118
Ultrasound in Medicine & Biology
showed irregular shape, irregular margin, and strong heterogeneous enhancement, with wider range than those of the B-mode US image. Case 3 (Invasive carcinoma of NST): B-mode US image showed hypoechoic mass with angular margin. CEUS image showed irregular shape, irregular margin, and strong homogeneous enhancement, with wider range than those of the B-mode US image. Case 4 (Invasive lobular carcinoma): B-mode US image showed irregular shape and hypoechoic pattern with a thick rim. CEUS image showed irregular shape, strong heterogeneous enhancement with wider range than those of the B-mode US image and plunging or penetrating vessels. Case 5 (Ductal carcinoma in situ): B-mode US image showed irregular shape and hypoechoic pattern with parallel orientation. CEUS showed irregular shape and strong heterogeneous enhancement with wider range than those of the B-mode US image. Conclusions: We clarified that the typical CEUS images of malignant breast tumors, were irregular enhancement, and a wider enhancement range than those of B-mode US. Another suggested finding associated with malignancy was plunging or penetrating vessels.
How many HCV cirrhotic patients go below cirrhotic cut-off values in transient elastography after direct acting agents treatment? Alin Lazar, Ioan Sporea, Raluca Lupusoru, Alina Popescu, Alexandra Deleanu, Isabel Dan, Roxana Sirli Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Introduction: Liver stiffness (LS) measurements by Transient Elastography (TE) has been accepted as a tool for fibrosis assessment. The aim of the study was to evaluate what happens with liver stiffness values after DAA (Direct-acting antivirals) therapy, in patients with compensated HCV cirrhosis, who had sustained virologic response (SVR) and to highlight in how many LS values become lower than the accepted cut-off for cirrhosis. Material & Method: A number of 167 patients with compensated HCV cirrhosis who had LS > 12 kPa at baseline, underwent a 12 weeks DAA therapy (Viekirax/Exviera) and had SVR. 56 of them were followed up by TE 24 weeks after EOT (end of treatment) and also 48 weeks after EOT (SVR 48). A subgroup of 28 patients were followed up 96 weeks after EOT (SVR 96). LS values were assessed by means of TE (FibroScan, Echosens) at the start of treatment (ST), at SVR 12 (12 weeks from EOT), SVR 24, SVR 48 and SVR 96, respectively. In each session, 10 valid liver stiffness measurements (LSM) were obtained and reliable LSM were defined as median value of 10 measurements with Interquartile range/median (IQR/M) 30%. Results: LS mean values at SVR12 were significantly lower as compared to ST (16.6 § 6.87 kPa vs 21.3 § 8.8, p = 0.002). As compared to SVR12, at SVR24 the mean LS values remained stable (16.6 § 6.87 vs 16.9 § 6.87 kPa, p = 0.81) and at SVR48 the values continued to decrease, but without statistical significance (14.6 § 5.3 vs 16.6 § 6.87 kPa, p = 0.08). LS was < 12 kPa in 14% of patients at SVR12, in 16% of patients at SVR24 and in 27% patients at SVR48. In the subgroup of 28 patients evaluated at SVR96, the mean LS values decreased significantly as compared to SVR12 (11.6 § 4.6 vs. 15.5 § 6.2 kPa, p = 0.009), and 46% had LS < 12 kPa. Conclusion: In compensated HCV cirrhotic patients, the mean LS values significantly decreased at SVR12, remained stable at SVR24 and decreased at SVR48; 14 % patients had LS values < 12 kPa at SVR12, 16% at SVR 24 and 27% at SVR 48. In the subgroup of patients followed up at SVR96, almost half had LS values lower than 12 kPa. Keywords: liver stiffness, direct-acting antivirals, compensated HCV cirrhosis.
Volume 45, Number S1, 2019 Pancreatic stiffness values using a point shear wave elastography technique in patients with healthy pancreas Alexandru Popa, Roxana Sirli, Ruxandra Mare, Alina Popescu, Mirela Danila, Ioan Sporea Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timi¸soara, Romania, Timisoara, Timis, Rom^ ania Background: In the current literature, there is only a small number of studies that have evaluated the utility of point share wave elastography for pancreatic assessment. Objective: To assess the feasibility of Virtual Touch Quantification (VTQ) elastography for pancreas assessment, as well as the mean pancreatic stiffness values in healthy subjects. Material and Method: We included 70 subjects (52.8% women, 47.2% men, average BMI = 25.9 § 4.9 kg/m2, average age 46.8 § 18.4 years) with a normal pancreatic ultrasound aspect and with no history of pancreatic disease or diabetes, in whom elastography measurements were performed with a Siemens Acuson S2000 Virtual Touch ultrasound system (Siemens AG, Erlangen, Germany) using a 4CI transducer. For each patient, 10 valid VTQ measurements of the pancreatic parenchyma were performed under fasting conditions. Reliable measurements were defined as a median value of ten pancreas stiffness measurements with a success rate 60% and an interquartile range interval < 30%. Results: Out of 70 subjects, reliable measurements were acquired in 61 subjects (87.1%) by means of VTQ elastography. The mean pancreas stiffness values in healthy subjects was 1.26 m/s § 0.1 m/s, CI 95% (1.24-1.28). There were no significant differences between the mean pancreas stiffness in men vs. women 1.25 m/s § 0.09 m/s, CI 95% (1.21-1.28) vs. 1.28 m/s § 0.1 m/s CI 95% (1.25-1.31) (p = 0.103). Conclusion: VTQ can be a useful tool for pancreas quantification characterized by a good feasibility (87.1%) in healthy subjects. The mean pancreas stiffness values in healthy individuals was 1.26 m/s § 0.1m/s. Keywords: point share wave elastography, pancreas assessment, healthy subjects. The prevalence of liver fibrosis stages assessed by Transient Elastography: a single center study Alin Lazar, Ioan Sporea, Alexandra Deleanu, Isabel Dan, Roxana Sirli Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Objective: The aim of the study was to highlight the prevalence of liver fibrosis stages assessed by means of transient elastography (TE) in large cohort of patients in a single study centre. Material & Method: 22400 liver stiffness (LS) assessments by mean of TE have been performed in our Department during an 11 years period (2007-2018). The study included patients with chronic liver diseases of various etiology. In each patient, 10 valid LS measurements were obtained either with M probe or with XL probe. If no valid LS measurements could be obtained, the evaluation was declared as failure. Reliable LSM were defined as median value of 10 measurements with Interquartile range/median (IQR/M) 30%, and a Success Rate (SR) 60%. To discriminate between LS stages by TE we used the following cut-offs (1): F2 - 7 kPa; F3 - 9.5 kPa and F4 - 12 kPa. Results: The feasibility in our cohort was 90.1%, 2238 of 22400 measurements (9.9%) were failed or unreliable. Based on TE cut-off values, the severity of liver fibrosis in our group was as follows: F < 2: 9783 patients (48.5%); F2: 3132 patients (15.6%); F3: 1714 patients (8.5%) and F4: 5533 patients (27.4%). Conclusion: Transient elastography had a feasibility of 90.1% in this large cohort, almost half of the patients (48.5%) having at most mild fibrosis, and approximately one quarter having cirrhosis (27.4%).
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.
S119
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.
Ultrasound in Medicine & Biology
showed irregular shape, irregular margin, and strong heterogeneous enhancement, with wider range than those of the B-mode US image. Case 3 (Invasive carcinoma of NST): B-mode US image showed hypoechoic mass with angular margin. CEUS image showed irregular shape, irregular margin, and strong homogeneous enhancement, with wider range than those of the B-mode US image. Case 4 (Invasive lobular carcinoma): B-mode US image showed irregular shape and hypoechoic pattern with a thick rim. CEUS image showed irregular shape, strong heterogeneous enhancement with wider range than those of the B-mode US image and plunging or penetrating vessels. Case 5 (Ductal carcinoma in situ): B-mode US image showed irregular shape and hypoechoic pattern with parallel orientation. CEUS showed irregular shape and strong heterogeneous enhancement with wider range than those of the B-mode US image. Conclusions: We clarified that the typical CEUS images of malignant breast tumors, were irregular enhancement, and a wider enhancement range than those of B-mode US. Another suggested finding associated with malignancy was plunging or penetrating vessels.
How many HCV cirrhotic patients go below cirrhotic cut-off values in transient elastography after direct acting agents treatment? Alin Lazar, Ioan Sporea, Raluca Lupusoru, Alina Popescu, Alexandra Deleanu, Isabel Dan, Roxana Sirli Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Introduction: Liver stiffness (LS) measurements by Transient Elastography (TE) has been accepted as a tool for fibrosis assessment. The aim of the study was to evaluate what happens with liver stiffness values after DAA (Direct-acting antivirals) therapy, in patients with compensated HCV cirrhosis, who had sustained virologic response (SVR) and to highlight in how many LS values become lower than the accepted cut-off for cirrhosis. Material & Method: A number of 167 patients with compensated HCV cirrhosis who had LS > 12 kPa at baseline, underwent a 12 weeks DAA therapy (Viekirax/Exviera) and had SVR. 56 of them were followed up by TE 24 weeks after EOT (end of treatment) and also 48 weeks after EOT (SVR 48). A subgroup of 28 patients were followed up 96 weeks after EOT (SVR 96). LS values were assessed by means of TE (FibroScan, Echosens) at the start of treatment (ST), at SVR 12 (12 weeks from EOT), SVR 24, SVR 48 and SVR 96, respectively. In each session, 10 valid liver stiffness measurements (LSM) were obtained and reliable LSM were defined as median value of 10 measurements with Interquartile range/median (IQR/M) 30%. Results: LS mean values at SVR12 were significantly lower as compared to ST (16.6 § 6.87 kPa vs 21.3 § 8.8, p = 0.002). As compared to SVR12, at SVR24 the mean LS values remained stable (16.6 § 6.87 vs 16.9 § 6.87 kPa, p = 0.81) and at SVR48 the values continued to decrease, but without statistical significance (14.6 § 5.3 vs 16.6 § 6.87 kPa, p = 0.08). LS was < 12 kPa in 14% of patients at SVR12, in 16% of patients at SVR24 and in 27% patients at SVR48. In the subgroup of 28 patients evaluated at SVR96, the mean LS values decreased significantly as compared to SVR12 (11.6 § 4.6 vs. 15.5 § 6.2 kPa, p = 0.009), and 46% had LS < 12 kPa. Conclusion: In compensated HCV cirrhotic patients, the mean LS values significantly decreased at SVR12, remained stable at SVR24 and decreased at SVR48; 14 % patients had LS values < 12 kPa at SVR12, 16% at SVR 24 and 27% at SVR 48. In the subgroup of patients followed up at SVR96, almost half had LS values lower than 12 kPa. Keywords: liver stiffness, direct-acting antivirals, compensated HCV cirrhosis.
Volume 45, Number S1, 2019 Pancreatic stiffness values using a point shear wave elastography technique in patients with healthy pancreas Alexandru Popa, Roxana Sirli, Ruxandra Mare, Alina Popescu, Mirela Danila, Ioan Sporea Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timi¸soara, Romania, Timisoara, Timis, Rom^ ania Background: In the current literature, there is only a small number of studies that have evaluated the utility of point share wave elastography for pancreatic assessment. Objective: To assess the feasibility of Virtual Touch Quantification (VTQ) elastography for pancreas assessment, as well as the mean pancreatic stiffness values in healthy subjects. Material and Method: We included 70 subjects (52.8% women, 47.2% men, average BMI = 25.9 § 4.9 kg/m2, average age 46.8 § 18.4 years) with a normal pancreatic ultrasound aspect and with no history of pancreatic disease or diabetes, in whom elastography measurements were performed with a Siemens Acuson S2000 Virtual Touch ultrasound system (Siemens AG, Erlangen, Germany) using a 4CI transducer. For each patient, 10 valid VTQ measurements of the pancreatic parenchyma were performed under fasting conditions. Reliable measurements were defined as a median value of ten pancreas stiffness measurements with a success rate 60% and an interquartile range interval < 30%. Results: Out of 70 subjects, reliable measurements were acquired in 61 subjects (87.1%) by means of VTQ elastography. The mean pancreas stiffness values in healthy subjects was 1.26 m/s § 0.1 m/s, CI 95% (1.24-1.28). There were no significant differences between the mean pancreas stiffness in men vs. women 1.25 m/s § 0.09 m/s, CI 95% (1.21-1.28) vs. 1.28 m/s § 0.1 m/s CI 95% (1.25-1.31) (p = 0.103). Conclusion: VTQ can be a useful tool for pancreas quantification characterized by a good feasibility (87.1%) in healthy subjects. The mean pancreas stiffness values in healthy individuals was 1.26 m/s § 0.1m/s. Keywords: point share wave elastography, pancreas assessment, healthy subjects. The prevalence of liver fibrosis stages assessed by Transient Elastography: a single center study Alin Lazar, Ioan Sporea, Alexandra Deleanu, Isabel Dan, Roxana Sirli Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Objective: The aim of the study was to highlight the prevalence of liver fibrosis stages assessed by means of transient elastography (TE) in large cohort of patients in a single study centre. Material & Method: 22400 liver stiffness (LS) assessments by mean of TE have been performed in our Department during an 11 years period (2007-2018). The study included patients with chronic liver diseases of various etiology. In each patient, 10 valid LS measurements were obtained either with M probe or with XL probe. If no valid LS measurements could be obtained, the evaluation was declared as failure. Reliable LSM were defined as median value of 10 measurements with Interquartile range/median (IQR/M) 30%, and a Success Rate (SR) 60%. To discriminate between LS stages by TE we used the following cut-offs (1): F2 - 7 kPa; F3 - 9.5 kPa and F4 - 12 kPa. Results: The feasibility in our cohort was 90.1%, 2238 of 22400 measurements (9.9%) were failed or unreliable. Based on TE cut-off values, the severity of liver fibrosis in our group was as follows: F < 2: 9783 patients (48.5%); F2: 3132 patients (15.6%); F3: 1714 patients (8.5%) and F4: 5533 patients (27.4%). Conclusion: Transient elastography had a feasibility of 90.1% in this large cohort, almost half of the patients (48.5%) having at most mild fibrosis, and approximately one quarter having cirrhosis (27.4%).
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.
S119
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.