Ultrasound is a non-invasive, real-time, inexpensive, radiation-free and easily repeatable method, usually used for liver imaging. In recent years, new ultrasound examination techniques for liver diseases such as contrast-enhanced ultrasound and elastography have been rapidly developed, which can effectively identify intrahepatic space-occupying lesions, assess the degree of liver fibrosis and portal hypertension, and monitor the effects of treatment. Therefore, these technologies play an important diagnostic role in clinical liver diseases and have therapeutic interventional value. This guideline classifies the instrument set-up, patient preparation, and physician examination methods through multimodal ultrasound examinations (gray-scale ultrasound, color Doppler ultrasound, contrast-enhanced ultrasound, elastic ultrasound) for liver diseases. In addition, liver diseases multimodal ultrasound technology diagnostic criteria for diffuse hepatic lesions (inflammatory lesions, fibrosis, and sclerosis), multiple space-occupying lesions, and interventional procedures have been defined and standardized. Concurrently, we also recommend the ultrasound monitoring time interval and diagnostic report writing standard for liver diseases.
Elasticity Imaging Techniques ; Humans ; Hypertension, Portal ; Liver/diagnostic imaging* ; Liver Cirrhosis ; Liver Diseases/diagnostic imaging* ; Ultrasonography

Chronic Disease ; Elasticity Imaging Techniques ; Humans ; Liver Diseases ; diagnostic imaging

Cardiomyopathy, Hypertrophic ; diagnostic imaging ; Humans ; Liver Diseases ; Ultrasonography

Diagnostic Imaging ; Humans ; Liver Diseases ; pathology ; Portal Vein ; pathology

Animals ; Humans ; Liver ; diagnostic imaging ; Liver Diseases ; diagnostic imaging ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Rats ; X-Ray Diffraction ; methods

Developments of contrast agent and imaging technique have made it possible for using contrast-enhanced ultrasound (CEUS) to assess perfusion. As an irradiative, real time and repeatable technique, ultrasound is revealing its advantages in this field compared with nuclear medicine, CT and MRI. This paper introduces the mechanism and methods of the CEUS in the perfusion ultrasound. The advancement in the study of the time-intensity curve (TIC) in systemic organs is also reviewed in this paper.
Animals ; Contrast Media ; Gastrointestinal Diseases ; diagnostic imaging ; Humans ; Kidney Diseases ; diagnostic imaging ; Liver Diseases ; diagnostic imaging ; Models, Theoretical ; Perfusion ; Ultrasonography ; methods ; trends

OBJECTIVETo evaluate the application of contrast-enhanced ultrasonography (CEUS) in diagnosis of inflammatory pseudotumor of liver (IPL).

METHODSThe contrast-enhanced untrasonography was performed in 32 cases of IPL and the results were retrospectively analyzed.

RESULTAmong total 32 cases, 21 had absent contrast enhancement (type I); 6 had rimlike or stringlike enhancement during arterial phase and presented hypoechoic lesions during the late phase (type II); 2 had diffuse and homogeneous enhancement during early arterial phase,persisting hyperechoic during the late phase (type III); 3 had enhancement during arterial phases and washed out more quickly than liver parenchymal (type IV).

CONCLUSIONThe perfusion pattern of IPL with CEUS varies, the predominant type is no contrast enhancement; type IV may be confused with atypical hepatic carcinoma, in that case the needle biopsy is necessary.

Adult ; Female ; Granuloma, Plasma Cell ; diagnostic imaging ; Humans ; Liver ; diagnostic imaging ; Liver Diseases ; diagnostic imaging ; Male ; Middle Aged ; Retrospective Studies ; Ultrasonography ; Young Adult

Adult ; Female ; Granuloma, Plasma Cell ; diagnosis ; diagnostic imaging ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray ; methods

OBJECTIVETo evaluate the value of angiography and cholangiography on the diagnosis and interventional treatment of vascular and biliary complications after liver transplantation.

METHODSSixteen of 46 patients (15 men and 1 woman, 17 - 60 years old) after orthotopic liver transplantation received angiography due to abnormal ultrasonography or edema of lower limbs, or cholangiography due to progressing jaundice. Percutaneous transluminal angioplasty or drainage was performed in some patients.

RESULTSFifteen patients experienced vascular complications and 4 patients had biliary complications. Three of them appeared to have both vascular and biliary complications. Hepatic artery complications were the most common complications (9/16), including hepatic artery thrombosis or stenosis (6/9), bleeding (2/9) and hepatic artery-dissecting aneurysm (1/9). One patient with hepatic artery thrombosis received transcatheter thrombolysis and two patients with bleeding received coil embolization. Inferior vena cava and portal vein stenosis were observed in 6 and 2 patients, respectively. After balloon angioplasty or stent placement, clinical symptoms were alleviated. Biliary complications, including biliary stricture and anastomotic bile leak, occurred in 4 patients. Jaundice decreased after percutaneous transhepatic cholangiography and drainage.

CONCLUSIONSBesides diagnosis, interventional methods include mini-invasive treatment for patients with vascular and biliary complications after liver transplantation. Balloon angiography and stent placement for venous stenosis are useful procedure for the treatment of these problems.

Adolescent ; Adult ; Biliary Tract Diseases ; diagnostic imaging ; therapy ; Cholangiography ; Female ; Hepatic Artery ; diagnostic imaging ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; Vascular Diseases ; diagnostic imaging ; therapy ; Vena Cava, Inferior ; diagnostic imaging

OBJECTIVETo compare the abilities of transient elastography (TE) versus real-time tissue elastography (RTE) for assessing liver fibrosis in patients with chronic liver disease.

METHODSNinetytwo patients with chronic liver disease were enrolled in the study, and included 77 cases of chronic hepatitis B, 4 cases of chronic hepatitis C, 4 cases of autoimmune liver disease, 2 cases of primary biliary cirrhosis, I case of abnormal bile duct development, and 4 cases of unknown etiology.All patients were assessed by both TE and RTE in a single day.The correlation coefficient of liver fibrosis level and the receiver operating characteristic (ROC) curve of S more than 2 and =4 of TE and RTE were determined.The values were compared using findings fiom pathological analysis as reference.

RESULTSThe correlation coefficient of liver fibrosis level was significantly higher for TE (r =0.755, 95% CI:0.651-0.831, P =0.000) than for RTE (r=0.481, 95% CI:0.306-0.624, P =0.000) (Z=3.07, P =0.002).The areas under the ROC curves for S more than 2 and =4 were 0.903 and 0.740 for TE and 0.915 and 0.786 for RTE, respectively, indicating that the performance of TE was superior to that of RTE.

CONCLUSIONTE was superior to RTE for assessment of liver fibrosis.

Autoimmune Diseases ; Elasticity Imaging Techniques ; Hepatitis B, Chronic ; diagnostic imaging ; Hepatitis C, Chronic ; diagnostic imaging ; Humans ; Liver Cirrhosis, Biliary ; diagnostic imaging ; ROC Curve