1
|
Early MRI predictors of disease-free survival in locally advanced rectal cancer from the GRECCAR 4 trial. Br J Surg 2019; 106:1530-1541. [PMID: 31436325 DOI: 10.1002/bjs.11233] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/05/2019] [Accepted: 04/14/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Tailored neoadjuvant treatment of locally advanced rectal cancer (LARC) may improve outcomes. The aim of this study was to determine early MRI prognostic parameters with which to stratify neoadjuvant treatment in patients with LARC. METHODS All patients from a prospective, phase II, multicentre randomized study (GRECCAR4; NCT01333709) were included, and underwent rectal MRI before treatment, 4 weeks after induction chemotherapy and after completion of chemoradiotherapy (CRT). Tumour volumetry, MRI tumour regression grade (mrTRG), T and N categories, circumferential resection margin (CRM) status and extramural vascular invasion identified by MRI (mrEMVI) were evaluated. RESULTS A total of 133 randomized patients were analysed. Median follow-up was 41·4 (95 per cent c.i. 36·6 to 45·2) months. Thirty-one patients (23·3 per cent) developed tumour recurrence. In univariable analysis, mrEMVI at baseline was the only prognostic factor associated with poorer outcome (P = 0·015). After induction chemotherapy, a larger tumour volume on MRI (P = 0·019), tumour volume regression of 60 per cent or less (P = 0·002), involvement of the CRM (P = 0·037), mrEMVI (P = 0·026) and a poor mrTRG (P = 0·023) were associated with poor outcome. After completion of CRT, the absence of complete response on MRI (P = 0·004), mrEMVI (P = 0·038) and a poor mrTRG (P = 0·005) were associated with shorter disease-free survival. A final multivariable model including all significant variables (baseline, after induction, after CRT) revealed that Eastern Cooperative Oncology Group performance status (P = 0·011), sphincter involvement (P = 0·009), mrEMVI at baseline (P = 0·002) and early tumour volume regression of 60 per cent or less after induction (P = 0·007) were associated with relapse. CONCLUSION Baseline and early post-treatment MRI parameters are associated with prognosis in LARC. Future preoperative treatment should stratify treatment according to baseline mrEMVI status and early tumour volume regression.
Collapse
|
2
|
Suspicious liver nodule in chronic liver disease: Usefulness of a second biopsy. Diagn Interv Imaging 2018; 99:493-499. [DOI: 10.1016/j.diii.2017.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/21/2017] [Accepted: 12/25/2017] [Indexed: 12/19/2022]
|
3
|
EP-1671: Inappropriate Radiologic Staging Examinations in Early-Stage Breast Cancer: A cost assessment. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
4
|
Selection of an early biomarker for vascular normalization using dynamic contrast-enhanced ultrasonography to predict outcomes of metastatic patients treated with bevacizumab. Ann Oncol 2016; 27:1922-8. [PMID: 27502701 DOI: 10.1093/annonc/mdw280] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/06/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dynamic contrast-enhanced ultrasonography (DCE-US) has been used for evaluation of tumor response to antiangiogenic treatments. The objective of this study was to assess the link between DCE-US data obtained during the first week of treatment and subsequent tumor progression. PATIENTS AND METHODS Patients treated with antiangiogenic therapies were included in a multicentric prospective study from 2007 to 2010. DCE-US examinations were available at baseline and at day 7. For each examination, a 3 min perfusion curve was recorded just after injection of a contrast agent. Each perfusion curve was modeled with seven parameters. We analyzed the correlation between criteria measured up to day 7 on freedom from progression (FFP). The impact was assessed globally, according to tumor localization and to type of treatment. RESULTS The median follow-up was 20 months. The mean transit time (MTT) evaluated at day 7 was the only criterion significantly associated with FFP (P = 0.002). The cut-off point maximizing the difference between FFP curves was 12 s. Patients with at least a 12 s MTT had a better FFP. The results according to tumor type were significantly heterogeneous: the impact of MTT on FFP was more marked for breast cancer (P = 0.004) and for colon cancer (P = 0.025) than for other tumor types. Similarly, the differences in FFP according to MTT at day 7 were marked (P = 0.004) in patients receiving bevacizumab. CONCLUSION The MTT evaluated with DCE-US at day 7 is significantly correlated to FFP of patients treated with bevacizumab. This criterion might be linked to vascular normalization. AFSSAPS NO 2007-A00399-44.
Collapse
|
5
|
Ultrasonographic assessment of liver fibrosis with computer-assisted analysis of liver surface irregularities. Diagn Interv Imaging 2015; 96:941-6. [DOI: 10.1016/j.diii.2015.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 01/06/2015] [Accepted: 02/16/2015] [Indexed: 01/10/2023]
|
6
|
Routine postoperative upper gastrointestinal fluoroscopy after laparoscopic sleeve gastrectomy: Is there still a utility? Diagn Interv Imaging 2015; 96:947-51. [PMID: 25686774 DOI: 10.1016/j.diii.2014.11.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 03/17/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the performance of routine esophagogastric transit studies (OGT) performed between day 2 (D2) and day 4 (D4) following sleeve gastrectomy for the diagnosis of gastric fistula. PATIENTS AND METHODS Single center study including 736 patients undergoing surgery for sleeve gastrectomy including 32 of whom developed gastric fistula. Seven hundred and twenty OGT on D2 and 86 abdominal and pelvic CT scans were performed to investigate for a fistula and whether or not a blood collection was present. Sensitivity, specificity, positive and negative predictive values, Youden index (YI) and dosimetry were calculated for both investigations. RESULTS The sensitivity and specificity of OGT for the diagnosis of fistula were 7% and 98% respectively with a PPV of 18%, an NPV of 96% and YI of 0.06. The mean DSP was 5500μGy.m(2). Sensitivity, specificity, positive and negative predictive values and Youden index for CT were 55%, 100%, 100%, 81%, 0.55, respectively for the presence of a fistula; and 96%, 86%, 78%, 98%, 0.83 for the presence of a non-blood collection and; 100%, 86%, 78%, 100%, 0.86 for the presence of a non-blood collection and/or fistula. The mean DLP was 3700 mGy.cm. CONCLUSION Because of its very poor sensitivity for the diagnosis of gastric fistula, the OGT on D2 needs to be reconsidered. CT performed on clinical suspicion appears to be a better diagnostic tool.
Collapse
|
7
|
Hepatic transarterial chemoembolization (HACE) with cisplatin in liver metastases from cutaneous melanoma: a prospective study of three patients. J Eur Acad Dermatol Venereol 2012; 27:e261-2. [PMID: 22691056 DOI: 10.1111/j.1468-3083.2012.04601.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
Ischémie aiguë du mésentère : apports de l’imagerie en coupes. ACTA ACUST UNITED AC 2011; 92:1060-71. [DOI: 10.1016/j.jradio.2011.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 04/05/2010] [Accepted: 03/22/2011] [Indexed: 12/21/2022]
|
9
|
1402 POSTER DISCUSSION CT Evaluation of the Response of Colorectal Liver Metastasis After Bevacizumab Treatment – a Density Quantitative Analysis Correlated With Patient Outcome. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70895-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
10
|
Quantitative density evaluation of liver metastases on CT scan: A new tool to evaluate early the benefit of bevacizumab plus chemothrapy regimen. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
11
|
|
12
|
CT-scan lung morphology predicts the response to a recruitment maneuver in acute respiratory distress syndrome patients. Crit Care 2009. [PMCID: PMC4083926 DOI: 10.1186/cc7204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
13
|
Adrenal gland evaluation in septic shock patients: preliminary results of the first CT-scan study. Crit Care 2009. [PMCID: PMC4084215 DOI: 10.1186/cc7493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
14
|
[Efficacy of prolonged-release somatostatin analog monotherapy in metastatic endocrine tumors]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2008; 32:989-991. [PMID: 18945567 DOI: 10.1016/j.gcb.2008.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 08/05/2008] [Accepted: 09/05/2008] [Indexed: 05/27/2023]
|
15
|
Role of contrast-enhanced ultrasound in the blinded assessment of focal liver lesions in comparison with MDCT and CEMRI: Results from a multicentre clinical trial. EJC Suppl 2008. [DOI: 10.1016/j.ejcsup.2008.06.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
16
|
[Rare vascular complication from acute pancreatitis: intra-hepatic false aneurysm of the hepatic artery: a report of 2 cases]. ACTA ACUST UNITED AC 2007; 88:1185-8. [PMID: 17878881 DOI: 10.1016/s0221-0363(07)89931-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Abstract
A liver incidentaloma corresponds to a liver lesion detected during work-up of for unrelated pathology. The frequency of incidentalomas is directly related to the incidence of liver tumors in the general population. After detection of an incidental liver lesion, the goal is to assess if diagnosis can be made based on imaging features alone or if biopsy is required. As such, radiologists must be familiar with the imaging features of different types of liver lesions, irrespective of the imaging modality. US is useful to determine the number of lesions (single versus multiple) and the cystic or solid nature of each lesion. Cystic lesions are usually benign. Incidental solid liver lesions are typically benign, but detection of a malignant lesion, hepatocellular carcinoma and metastases, is possible. The most frequent benign incidental solid liver lesions are hemangioma, focal nodular hyperplasia and liver cell adenoma. Accurate imaging diagnosis may not always be achievable, and biopsy, percutaneous or surgical, may be required.
Collapse
|
18
|
Abstract
Das primäre Angiosarkom der Aorta ist eine sehr seltene Erkrankung. Die Prognose ist aufgrund der thromboembolischen Komplikationen und sehr früher Metastasierung schlecht. Die mittlere Überlebenszeit nach Diagnosestellung beträgt 9 Monate. Die Diagnose ist schwierig und wird häufig erst postmortal gestellt. Wir berichten von einer 68-jährigen Patientin, die uns wenige Wochen nach Resektion eines Angiosarkoms des Duodenums aufgrund einer Thrombose der A. mesenterica superior überwiesen wurde. Die diagnostische Abklärung brachte ein zuvor übersehenes primäres metastasierendes Angiosarkom der Thoraxaorta zum Vorschein.
Collapse
|
19
|
Laparoscopic vertical banded gastroplasty. A multicenter prospective study of 200 procedures. Surg Endosc 2006; 21:870-4. [PMID: 17103270 DOI: 10.1007/s00464-006-9048-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 05/15/2006] [Accepted: 06/07/2006] [Indexed: 02/01/2023]
Abstract
BACKGROUND The commonest surgical procedure for management of morbid obesity in Europe is laparoscopic adjustable gastric banding (LAGB), even though laparoscopic vertical banded gastroplasty (LVBG) is still considered to be a gold standard restrictive option in bariatric surgery. A multicenter prospective study was designed to to assess the efficacy of LVBG in terms of weight loss and complication rates for obese patients who have indications for a restrictive procedure. PATIENTS AND METHODS Two-hundred morbidly obese patients (84.5% female) with a mean age of 41 years and mean body mass index (BMI) of 43.2 kg/m(2) underwent LVBG as described by MacLean. Five trocars were placed in standard positions as per laparoscopic upper gastrointestinal surgery. A vertical gastric pouch (30 ml) was created with circular (21 or 25mm) and endolinear stapling techniques, enabling definitive separation of the two parts of the stomach. The gastric outlet was calibrated with either a polypropylene mesh (5.5 cm in length and 1cm in width) or a nonadjustable silicone band. The median follow-up period was 30 months (range, 1-72 months). RESULTS One case had to be converted to open surgery (gastric perforation) and there was one death secondary to peritonitis of unknown etiology. The morbidity rate was 24%, comprising the following complications: gastric outlet stenosis (8%); staple line leak (2.5%); food trapping (1.5%); peritonitis (1%); thrombophlebitis (1.5%); pulmonary embolism (0.5%); and gastroesophageal reflux (9%). The excess weight loss achieved was 56.7% (1 year), 68.3% (2 years), and 65.1% (3 years). CONCLUSIONS Laparoscopic vertical banded gastroplasty is an effective procedure for the surgical management of morbid obesity, especially for patients who present hyperphagia but are unable to manage the constraints of adjustable gastric banding. Laparoscopic vertical banded gastroplasty is safe, as demonstrated by an acceptable complication rate, of which gastric outlet stenosis, staple line leakage, and gastroesophageal reflux predominate.
Collapse
|
20
|
C16 - Étude du contenu hépatique en fer par IRM dans la porphyrie cutanée tardive : analyse prospective chez 15 patients. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79637-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
21
|
Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc 2005; 19:947-50. [PMID: 15920690 DOI: 10.1007/s00464-004-2183-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2004] [Accepted: 01/17/2005] [Indexed: 12/18/2022]
Abstract
BACKGROUND Experience was gained management of intra-gastric migration of adjustable gastric banding. METHODS From July 1996 to January 2003, 4236 patients who underwent laparoscopic adjustable gastric banding were proposed for routine follow-up. Gastrograms were performed in case of band adjustment. Radiological controls and endoscopy were performed according to symptoms. RESULTS A total of 45 cases of band migration (1.6%) were diagnosed during follow-up. All but one of the migrated bands were removed laparoscopically either by a dissection outside the stomach or through a short gastrotomy. Mortality was 0% and morbidity 8% (n = 4). CONCLUSION The risk of an intragastric band migration remains low in the literature but could grow on account of the longer follow-up of patients. The retrieval of the band is the gold standard and must be planned promptly or delayed according to symptoms.
Collapse
|
22
|
Abstract
The authors report a case of perforated diverticulitis with presence of a fistulous tract between a peridiverticular abscess and the uterus during pregnancy with favorable outcome under medical treatment. The purpose of this case report is to illustrate specific imaging findings and clinical management of diverticulitis during pregnancy.
Collapse
|
23
|
[Multidetector CT and MRI in diseases of the gastrointestinal tract]. JOURNAL DE RADIOLOGIE 2003; 84:499-513; discussion 514-5. [PMID: 12844073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
UNLABELLED With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extramural components of the disease, and has a major role in the preoperative staging and the follow-up. Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for "virtual endoscopy", lead to discuss new indications in which CT could now compete with conventional X-rays series and videoendoscopy. This precise study of the digestive wall, the peridigestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endoluminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall. LEARNING OBJECTIVES to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT and MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future. CONCLUSION CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI.
Collapse
|
24
|
[Acute appendicitis: to image or not to image?]. JOURNAL DE RADIOLOGIE 2002; 83:1952-60. [PMID: 12592155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Acute appendicitis is frequently clinically suspected. However, about 50% of emergency room patients with such a diagnosis do not have acute appendicitis and between 20-25% of patients undergoing appendectomy based on clinical diagnosis have a normal appendix. On the other hand, if left untreated acute appendicitis may result in peritonitis. The purpose of this article is to review the indications for imaging patients with clinical suspicion of acute appendicitis, to describe the US and CT features of acute appendicitis, to review the advantages and limitations of US and CT, and to present the differential diagnosis to be considered in patients with right lower quadrant pain.
Collapse
|
25
|
Metastatic pudendal nerve compression presenting as atypical sciatica. JOURNAL OF SPINAL DISORDERS & TECHNIQUES 2002; 15:324-5. [PMID: 12177550 DOI: 10.1097/00024720-200208000-00011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A rare case of Alcock's syndrome caused by tumoral compression of the pudendal nerve is reported. Spine surgeons must be aware of the possibility of Alcock's syndrome in patients presenting with atypical sciatica.
Collapse
|
26
|
Changes in renal artery resistance after meal-induced splanchnic vasodilatation in cirrhotic patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 2001; 29:506-512. [PMID: 11745861 DOI: 10.1002/jcu.10016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE A relationship between vasomotor tone changes in mesenteric and renal vessels in cirrhotic patients has been suspected but remains controversial. The aim of this study was to assess by duplex Doppler sonography the changes in the circulatory resistance of the renal arteries and superior mesenteric artery (SMA) following meal-induced splanchnic vasodilatation. METHODS Twenty-seven cirrhotic patients and 15 healthy volunteers with no hepatic or renal dysfunction were prospectively included in the study. The resistance index (RI) of the SMA and of the right and left renal arteries was measured by duplex Doppler sonography before and 30 minutes after ingestion of a standard 400-kcal balanced liquid meal. Values in controls and patients and values before and after the meal were compared, and correlations between RIs, Child-Pugh class (liver function), and creatinine clearance were assessed in cirrhotic patients. RESULTS The fasting renal artery RI was greater in cirrhotic patients than in controls (p < 0.0001), but there was no difference in fasting SMA RIs. After the meal, there was a significant decrease in the SMA RI in controls (0.85 +/- 0.04 before versus 0.74 +/- 0.03 after meal, p = 0.0001) and in cirrhotic patients (0.85 +/- 0.04 before versus 0.77 +/- 0.04 after, p = 0.0001) and a significant increase in the renal artery RI (0.57 +/- 0.06 before versus 0.62 +/- 0.05 after in controls, p = 0.001; 0.68 +/- 0.07 before versus 0.70 +/- 0.07 after in cirrhotic patients, p = 0.001). No correlation was found in cirrhotic patients between the changes in renal artery RI and the postprandial SMA RI decrease, the Child-Pugh class, or the creatinine clearance. CONCLUSIONS Meal-induced SMA vasodilatation (RI decrease) is associated with a marked increase in the renal artery RI, worsening the renal vasoconstriction in cirrhotic patients.
Collapse
|
27
|
[Magnetic resonance cholangiography: dream or reality?]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2000; 24:875-6. [PMID: 11084421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
28
|
Doppler study of mesenteric, hepatic, and portal circulation in alcoholic cirrhosis: relationship between quantitative Doppler measurements and the severity of portal hypertension and hepatic failure. Hepatology 1998; 28:932-6. [PMID: 9755228 DOI: 10.1002/hep.510280406] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To determine the relationship between quantitative Doppler parameters of portal, hepatic, and splanchnic circulation and hepatic venous pressure gradient (HVPG), variceal size, and Child-Pugh class in patients with alcoholic cirrhosis, we studied forty patients with proved alcoholic cirrhosis who underwent Doppler ultrasonography, hepatic vein catheterization, and esophagoscopy. The following Doppler parameters were recorded: time-averaged mean blood velocity, volume flow of the main portal vein flow, and resistance index (RI) of the hepatic and of the superior mesenteric artery. Doppler findings were compared with HVPG, presence and size of esophageal varices, and Child-Pugh class. There was a significant inverse correlation between portal velocity and HVPG (r = -.69), as well as between portal vein flow and HVPG (r = -.58). No correlation was found between RI in the hepatic artery or superior mesenteric artery and HVPG. No correlation was found between portal vein measurements and presence and size of varices. Severe liver failure was associated with lower portal velocity and flow. In patients with alcoholic cirrhosis, only portal vein blood velocity and flow, but neither hepatic nor mesenteric artery RI, are correlated to the severity of portal hypertension and to the severity of liver failure.
Collapse
|
29
|
Iliotibial band friction syndrome: sonographic findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 1998; 17:257-260. [PMID: 9544609 DOI: 10.7863/jum.1998.17.4.257] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|
30
|
[Duplex Doppler sonography of splanchnic circulation in man. Clinical and physiological importance]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 1998; 22:394-404. [PMID: 9762268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
|
31
|
Doppler study of fasting and postprandial resistance indices in the superior mesenteric artery in healthy subjects and patients with cirrhosis. JOURNAL OF CLINICAL ULTRASOUND : JCU 1998; 26:131-136. [PMID: 9502035 DOI: 10.1002/(sici)1097-0096(199803/04)26:3<131::aid-jcu4>3.0.co;2-n] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE We assessed the resistance index (RI) in the superior mesenteric artery under fasting and postprandial conditions in healthy subjects and in patients with cirrhosis to determine whether the amount of change in the RI reflects the presence or severity of liver dysfunction. METHODS Fifteen subjects with normal livers and 27 patients with cirrhosis underwent Doppler sonography of the superior mesenteric artery before and after ingesting a standard meal. The RI at baseline (fasting state) and the postprandial RI were compared between the 2 groups. The fasting RIs and post postprandial RIs changes in cirrhotic patients were correlated with the severity of disease. RESULTS No difference was found between the baseline RIs in healthy (RI = 0.85) and cirrhotic subjects (RI = 0.84), nor was there a difference in baseline RIs between subgroups of cirrhotic patients according to the severity of liver disease. The RI decreased significantly (p < 0.05) after the meal in both the healthy (13%) and cirrhotic (8%) subjects, but the postprandial decrease was significantly less pronounced (p < 0.05) in cirrhotic patients than in healthy subjects. Among cirrhotic patients, there was no correlation between the postprandial decrease of the RI and severity of liver disease. CONCLUSIONS The marked decrease in the postprandial RI in the SMA in healthy subjects is generally not seen in patients with cirrhosis, and changes in the postprandial RI do not reliably predict the severity of liver dysfunction.
Collapse
MESH Headings
- Adult
- Aged
- Digestion/physiology
- Eating
- Fasting/physiology
- Female
- Hepatitis/diagnostic imaging
- Hepatitis/physiopathology
- Humans
- Liver/blood supply
- Liver/diagnostic imaging
- Liver Cirrhosis/diagnostic imaging
- Liver Cirrhosis/physiopathology
- Liver Cirrhosis, Alcoholic/diagnostic imaging
- Liver Cirrhosis, Alcoholic/physiopathology
- Liver Cirrhosis, Biliary/diagnostic imaging
- Liver Cirrhosis, Biliary/physiopathology
- Male
- Mesenteric Artery, Superior/diagnostic imaging
- Mesenteric Artery, Superior/physiology
- Middle Aged
- Probability
- Reproducibility of Results
- Severity of Illness Index
- Ultrasonography, Doppler, Duplex
- Ultrasonography, Doppler, Pulsed
- Vascular Resistance/physiology
Collapse
|