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

Nonalcoholic and alcoholic rabbit models of fatty liver were established by feeding on high-fat diet and alcohol, respectively, and fatty liver stiffness at different pathological stages was assessed with real-time shear-wave elastography (SWE), so as to investigate the fibrosis process during the development of fatty liver. The fatty liver stiffness of rabbit in nonalcoholic and alcoholic groups was higher than that in the control group, and that in alcohol group was higher than that in the nonalcoholic group (P<0.01). The elasticity modulus of liver in fatty liver rabbits of nonalcoholic and alcoholic groups showed a positive correlation with progression of liver fibrosis (P<0.01). Real-time SWE, as a noninvasive diagnostic method, can objectively reflect the liver stiffness change and progression of liver fibrosis during the development of fatty liver.
Animals ; Elasticity ; Elasticity Imaging Techniques ; methods ; Fatty Liver, Alcoholic ; complications ; diagnostic imaging ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Male ; Non-alcoholic Fatty Liver Disease ; complications ; diagnostic imaging ; Rabbits

OBJECTIVETo study ability of FibroScan (FS) in diagnosing the size of oesophageal varices (OV) in patients with HBV-related cirrhosis.

METHODSA total of 158 patients with HBV-related liver cirrhosis were enrolled in the study. The relation between the presence of OV assessed by endoscopy, and liver stiffness measurement by Fibroscan was studied, and ROC curves were drawn to assess the diagnostic ability of FS value.

RESULTSFor the patients without OV, mild OV, moderate OV, and severe OV, their corresponding FS values were (21.7 +/- 9.9) kPa, (32.1 +/- 13.6) kPa, (42.3 +/- 20.0) kPa and (54.5 +/- 16.2) kPa, respectively. Significant difference was found among the groups (P < 0.001) and also between any two groups (P < 0.05). ROC curve for the diagnosis of with vs. without OV, moderate OV, and < severe vs. severe OV were 0.798 (95% CI: 73.1%-86.5%), 0.823 (95% CI: 74.5%-90.0%) and 0.879 (95% CI: 80.8%-95.0%), respectively, with corresponding FS cut-off value of 23.3 kPa, 31.5 kPa and 34.6 kPa.

CONCLUSIONLiver stiffness measurement allows to predict the sizes of oesophageal varices in patients with HBV-related cirrhosis.

Adult ; Elasticity Imaging Techniques ; methods ; Esophageal and Gastric Varices ; diagnosis ; diagnostic imaging ; etiology ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis ; complications ; diagnostic imaging ; Male ; Middle Aged

To compare transient elastorgaphy (FibroTouch) and acoustic radiation force impulse (ARFI) in diagnosis of liver fibrosis in patients with chronic hepatitis B.One hundred and forty five patients with chronic hepatitis B underwent FibroTouch and ARFI examinations in Xixi Hospital of Hangzhou from January to November 2015. The liver stiffness (LSM) was detected by FibroTouch and the liver shear wave velocity (VTQ) was detected by ARFI; liver biopsy was performed in all patients. With biopsy results as gold standards, the diagnostic values of FibroTouch and ARFI for liver fibrosis were analyzed with Spearman correlation analysis and receiver operating characteristic (ROC) curve.The correlation coefficient of FibroTouch and ARFI was 0.746 (<0.01). FibroTouch and ARFI were significantly correlated with pathological stage determined by liver biopsy(=0.705 and 0.727, all<0.01). When 8.4 kPa was taken as the cut-off value of LSM and 1.49 m/s was taken as the cut-off value of VTQ, the areas under ROC (AUCs) were 0.857 and 0.836 (>0.05) in diagnosis of fibrosis S≥2 stage; when 10.8 kPa of LSM and 1.49 m/s of VTQ were used as cut-off values, the AUCs were 0.872 and 0.881 (>0.05) in diagnosis of S≥3 stage; when 12.3 kPa of LSM and 1.81m/s of VTQ were used as cut-off values, the AUCs were 0.875 and 0.888 (>0.05) in diagnosis of S=4 stage.Both FibroTouch and ARFI can be effectively used in evaluation of liver fibrosis in patients with chronic hepatitis B.
Biopsy ; Elasticity Imaging Techniques ; instrumentation ; methods ; Hepatitis B, Chronic ; complications ; diagnostic imaging ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Predictive Value of Tests ; ROC Curve

OBJECTIVETo investigate the diagnostic value of acoustic radiation force impulse (ARFI) imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.

METHODSOne-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis. The correlation between liver fibrosis grades determined by the two approaches was analyzed. The cut-off values for diagnosis by ARFI (S more than 2, S more than 3 and S = 4) were determined by generating a receiver operating characteristic (ROC) curve.

RESULTSThe spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26+/-0.27) m/s (n = 36), S2 at (1.45+/-0.51) m/s (n = 31), S3 at (2.01+/-0.54) m/s (n = 27), and S4 at (2.28+/-0.82) m/s (n = 14). The ARFI values were significantly different among the four different stages of liver fibrosis (P less than 0.001). The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient: 0.61, P less than 0.001). Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S more than 2 patients, of 0.863 for S more than 3 patients, and of 0.0880 for S = 4 patients.

CONCLUSIONThe real-time ultrasound elastography ARFI technology can show the elasticity modulus of liver, and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients. ARFI technology is easy to operate, non-invasive, and quantitative, and has potential clinical value for assessing liver fibrosis in CHC.

Adolescent ; Adult ; Aged ; Elasticity Imaging Techniques ; Female ; Hepatitis C, Chronic ; complications ; diagnostic imaging ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Young Adult

We report on a case of a 57-year-old male who underwent a curative resection for hepatocellular carcinoma (HCC) with histological confirmation of a spontaneously necrotized tumor. Initial serum AFP level was 4,778 ng/mL. A 3.7 cm hyperechoic mass in segment 6 of the liver was observed on ultrasonography and dynamic contrast-enhanced liver MRI showed a 3.7x3.1 cm sized HCC. He was scheduled to undergo curative surgical resection under the clinical diagnosis of an early stage HCC (Barcelona Clinic Liver Cancer stage A). Without treatment, the serum AFP level declined rapidly to 50 ng/mL over five weeks. He underwent curative wedge resection of segment 6 of the liver. Histology revealed complete necrosis of the mass rimmed by inflamed fibrous capsule on a background of HBV-related cirrhosis with infiltration of lymphoplasma cells. Exact pathophysiology underlying this event is unknown. Among the proposed mechanisms of spontaneous neoplastic remission of HCC, circulatory disturbance and activation of host immune response offer the most scientific explanation for the complete histologic necrosis of HCC in the resected mass seen in our patient.
Carcinoma, Hepatocellular/*diagnosis/diagnostic imaging/pathology ; Hepatitis B/complications/diagnosis ; Humans ; Liver/diagnostic imaging/pathology ; Liver Cirrhosis/etiology ; Liver Neoplasms/*diagnosis/diagnostic imaging/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Necrosis ; Radiography ; Remission, Spontaneous ; Ultrasonography ; alpha-Fetoproteins/analysis

OBJECTIVETo investigate the blood flow characteristics of hepatitis B cirrhosis based on Couinaud's hepatic segments and to analyze the correlation between perfusion parameters of liver cirrhosis in the hepatic segments and between the different Child-Pugh classifications by using the pattern of whole liver perfusion detected by multi-slice spiral computed tomography (MSCT).

METHODSWhole-liver perfusion enhanced CT imaging scan was performed for 51 patients with hepatitis B cirrhosis (including 24 classified as Child-Pugh A, 19 as Child-Pugh B, and 8 as Child-Pugh C) and 20 patients without any liver abnormalities (who served as the control group).The perfusion parameters of Couinaud's segments were measured in order to compare the blood perfusion differences among the Couinaud's hepatic segments in liver cirrhosis. The blood flow characteristics were analyzed for each lobe and compared between groups, and the time to peak and peak of enhancement values of the aorta and portal veins and spleen were recorded and compared between groups.The F-test was used for statistical analysis.

RESULTSThe liver cirrhosis group showed higher time to peak for aorta and portal veins and spleen but lower peak of enhancement values than the control group. The hepatic arterial perfusion (HAP) was significantly higher in segment 3 than in segment 7 were (11.40+/- 5.72 vs.9.46+/-5.18 mL/min/100 mL; P less than 0.05). In addition, the differences of the portal venous perfusion (PVP) and total hepatic perfusion (THP) were significant between the liver lobes in various groups (P less than 0.05). The HAP and hepatic perfusion index (HPI) were not significantly different between the groups, but the HAP and HPI in every lobe were higher in the Child C subgroup than in either the Child A or Child B subgroups.

CONCLUSIONThe cirrhotic liver has different blood flow in the various Couinaud's segments. Whole-liver perfusion MSCT can reflect the hemodynamic changes of liver cirrhosis and Child-Pugh classification, and as such may be helpful for distinguishing the normal liver from the cirrhotic liver.

Hemodynamics ; Hepatic Artery ; Hepatitis B ; complications ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Liver Neoplasms ; Perfusion ; Perfusion Imaging ; Portal Vein ; Spleen ; Tomography, Spiral Computed

Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

Alcohol Drinking ; adverse effects ; Hepatitis, Viral, Human ; complications ; diagnostic imaging ; pathology ; Hepatocytes ; pathology ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis, Alcoholic ; diagnostic imaging ; etiology ; pathology ; Liver Diseases, Alcoholic ; diagnostic imaging ; etiology ; pathology ; Liver Neoplasms ; epidemiology ; etiology ; pathology ; Prognosis ; Radiography ; Risk Factors