No abstract available.
Female ; Hepatitis B, Chronic/*ultrasonography ; Humans ; Male

BACKGROUND: It is common to find enlarged lymph nodes within hepatoduoedenal ligament during ultrasonography in patients with chronic hepatitis B. But, its clinical significance has not been clearly understood. METHODS: Lymph node volume within the hepatoduodenal ligament in 50 patients with chronic hepatitis B and 15 healthy controls was evaluated using ultrasonography. In patients with chronic hepatitis B, possible correlation of lymph node volume with biochemical tests, hepatitis activity index, and hepatitis B viremia was investigated. RESULTS: One or more lymph nodes were detected in 48 (96%) out of 50 patients with chronic hepatitis B (volume=3.4+/-2.4 mL, mean+/-S.D.) and 2 (13%) out of 15 controls (volume=0.4 mL, 0.6 mL). In chronic hepatitis B, lymph node volume showed a significant correlation with serum AST (r=0.66), ALT (r=0.63), gammaGT (r=0.53), total score of histologic activity index (r=0.59), and necroinflammatory score (r=0.59, p<0.05 for all); but not with fibrosis score and serum hepatitis B viremia. CONCLUSION: Enlarged perihepatic lymph nodes reflects histologic and biochemical inflammatory activity of the liver in chronic hepatitis B.
Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Ligaments ; Liver* ; Lymph Nodes* ; Ultrasonography ; Viremia

PURPOSE: This study was conducted to investigate whether the presence of patchy echogenicity in the liver of patients with chronic hepatitis B (CHB) is predictive of liver stiffness. METHODS: A total of 200 CHB patients with and without patchy echogenicity of the liver were assigned to two groups, with 100 patients in each group, and 32 of them underwent liver biopsy. Additionally, 80 healthy subjects, 100 inactive HBV carriers, and 100 patients with decompensated hepatic cirrhosis were assigned to the control groups. Laboratory tests and clinical data were collected, and shear wave velocity (SWV) of the liver was measured for all 480 subjects. RESULTS: The median SWV in patients with a normal liver, inactive hepatitis B virus carriers, CHB patients with and without patchy echogenicity, and decompensated hepatic cirrhosis were 1.07 m/sec, 1.08 m/sec, 1.16 m/sec, 1.16 m/sec, and 2.02 m/sec, respectively; there was no significant difference in SWV values between CHB patients with patchy echogenicity and those without patchy echogenicity. Furthermore, among CHB patients with and without patchy echogenicity, no significant difference in SWV was found according to fibrosis stage. CONCLUSION: The presence of patchy echogenicity of the liver does not indicate a higher degree of liver stiffness.
Biopsy ; Elasticity ; Fibrosis ; Healthy Volunteers ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver ; Ultrasonography

BACKGROUND/AIMS: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. METHODS: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. RESULTS: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. CONCLUSIONS: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.
Alanine Transaminase ; Carcinoma, Hepatocellular ; Cohort Studies ; DNA ; Fibrosis ; Follow-Up Studies ; Hepatitis B virus ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis ; Humans ; Liver Cirrhosis ; Liver ; Male ; Retrospective Studies ; Ultrasonography

PURPOSE: To evaluate the usefulness of screening liver ultrasonography (US) for hepatocellular carcinoma (HCC) detection in patients with chronic hepatitis or hepatic cirrhosis caused by hepatitis B virus (HBV). MATERIALS AND METHODS: A retrospective study was performed with 1,189 patients with clinical hepatopathy caused by HBV who underwent screening liver US for HCC detection at least twice. All patients were followed up with liver US examinations (mean, 8.3 times), CT, or MR for at least 3 months (range, 3-102 months; mean, 47 months) for the detection of HCC. The study population was divided into two groups: chronic hepatitis (n=492) and hepatic cirrhosis (n=697), which was further divided into two groups with (n=156) or without (n=541) evident shrinkage. The radiologic examinations that had detected HCC for the first time were analyzed and compared between the groups. RESULTS: Among 20 (4.1%) patients with chronic hepatitis and 132 (18.9%) patients with hepatic cirrhosis diagnosed as HCC, screening US was the modality of detection in 17 (85.0%) of 20 patients with chronic hepatitis and 76 (57.6%) of 132 patients with hepatic cirrhosis (p=0.038, Chi-square test). The detection rate of HCC on screening US between the chronic hepatitis and hepatic cirrhosis with evident shrinkage (51.4%, 19/37) showed a significant difference (p=0.027, Chi-square test). CONCLUSION: For chronic liver disease caused by HBV, screening US for HCC detection is more useful in patients with chronic hepatitis than with hepatic cirrhosis with evident shrinkage.
Carcinoma, Hepatocellular* ; Early Detection of Cancer ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Liver ; Liver Cirrhosis* ; Liver Diseases ; Mass Screening* ; Retrospective Studies ; Ultrasonography*

Hepatitis B, Chronic ; complications ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis ; diagnostic imaging ; etiology ; pathology ; Ultrasonography

Hepatoblastoma is a primary embryonic liver tumor usually found in children. It extremely rarely occurs in adults. We report a case of hepatoblastoma in a 56 year old man with chronic hepatitis B of 10years duration. Laboratory investigation of the patient on admission showed a marked elevation of alpha-fetoprotein in serum. Ultrasonography and Computerized tomography scan revealed a primary tumor, 6x7cm in size, in the right lobe. The tumor removed by a right lobectomy. Complete removal of the tumor is the treatment which is potentially curative provided that lesion is confined within the liver capsule. The literature revealed and a case of this tumor reviewed.
Adult* ; alpha-Fetoproteins ; Child ; Hepatitis B, Chronic ; Hepatoblastoma* ; Humans ; Liver ; Middle Aged ; Ultrasonography

Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case of partial agenesis of dorsal pancreas was reported. This case was not associated with diabetes mellitus and pancreatic exocrine dysfunction, or abdominal pain. A 37-year-old man with chronic hepatitis B visited to our hospital due to further examination for chronic hepatitis B. Abdominal ultrasonography showed enlarged pancreatic head. Diagnosis was made by endoscopic retrograde cholangiopancreatography and computed tomography. Explor-laparotomy was not done.
Abdominal Pain ; Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Diagnosis ; Head ; Hepatitis B, Chronic ; Humans ; Pancreas ; Ultrasonography

Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome. Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.
Adult ; Hepatitis B, Chronic/complications ; Humans ; Liver Cirrhosis/etiology/*therapy ; *Liver Transplantation ; Male ; Mesenteric Veins/*ultrasonography

BACKGROUND AND AIMS: FibroScan(R) is a new medical device that noninvasively measures liver stiffness. The aim of this study was to assess the accuracy of the liver stiffness measurement by FibroScan(R) for making the diagnosis of liver fibrosis in patients with chronic viral hepatitis. METHODS: We studied 103 patients with chronic viral hepatitis B or C and they underwent FibroScan(R) and liver biopsy between October 2005 and August 2006. Liver fibrosis was staged on a 0-4 scale according to the Korean Society of Pathologists Scoring System. The diagnostic accuracy was assessed by analysis of the receiver operator characteristics (ROC). RESULTS: The liver stiffness was 3.5-57.1 kPa (mean: 11.8, SD: 8.9). The mean value of liver stiffness in each fibrosis stage group (F1, F2, F3 and F4) was 5.8+/-1.8 kPa, 11.3+/-6.8 kPa, 11.8+/-6.0 kPa and 23.4+/-16.5 kPa, respectively. Liver stiffness measured by FibroScan(R) showed reliable correlation with the liver fibrosis stage as confirmed by liver biopsy (r=0.56, p<0.001). The AUROC (95% CI) of > or = F2, > or = F3 and F4 was 0.93 (0.86-0.99), 0.72 (0.62-0.82) and 0.80 (0.67-0.92), respectively. The sensitivity and specificity of 7.5 kPa, which was the cutoff value for > or = F2, was 84% and 90%, respectively. CONCLUSIONS: FibroScan(R) is a reliable method for the diagnosis of significant fibrosis (> or =F2) and cirrhosis in patients with chronic liver disease. The liver stiffness measurement by FibroScan(R) showed good diagnostic performance for significant fibrosis.
Adult ; Aged ; Disease Progression ; Female ; Hepatitis B, Chronic/complications/*ultrasonography ; Hepatitis C, Chronic/complications/*ultrasonography ; Humans ; Liver/*ultrasonography ; Liver Cirrhosis/etiology/*ultrasonography ; Male ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity