CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture

2021 ◽  
pp. 1-12
Author(s):  
Bo-wen Zheng ◽  
Shu-hong Yi ◽  
Tao Wu ◽  
Mei Liao ◽  
Ying-cai Zhang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Predictive Value ◽  
Biliary Stricture ◽  
Characteristic Curve ◽  
Validation Group ◽  
Gamma Glutamyl Transpeptidase ◽  
Full Cohort ◽  
Non Invasive ◽  
Invasive Method ◽  
Nas Score

BACKGROUND: Biliary ischaemia is an important factor in the pathogenesis of non-anastomotic biliary stricture (NAS) after liver transplantation (LT). Contrast-enhanced ultrasound (CEUS) can be used to detect biliary ischaemia, but no study has examined the utility of CEUS in predicting NAS. OBJECTIVE: To evaluate whether repeated CEUS as a non-invasive method of biliary ischaemia can identify NAS. METHODS: Consecutive LT patients who underwent CEUS examinations at 1–4 weeks after LT from September 2012 to December 2015 at our institution were included. The CEUS images and clinical data were analysed. RESULTS: Among 116 eligible LT patients, 39 (33.6%) were diagnosed with NAS within 1 year after LT. The patients with NAS had a significantly higher CEUS score at weeks 2–4 (all P <  0.05) and a higher slope of CEUS score progression (0.480 vs –0.044, P <  0.001). The accuracy of CEUS in identifying NAS improved over time after LT, reaching its maximum at week 4, with a sensitivity of 66.7%, a specificity of 87.9%, a positive predictive value (PPV) of 75.9%, a negative predictive value (NPV) of 82.3%, and an accuracy of 80.2%in the full cohort when a CEUS score≥3 was used as the cut-off. Multivariate analysis identified gamma-glutamyl transpeptidase (GGT), alanine transaminase (ALT) and the CEUS score at week 4 as independent predictors of NAS. In the task of identifying NAS, an NAS score combining the above 3 variables at week 4 showed areas under the receiver operating characteristic curve of 0.88 (95%CI, 0.78–0.99) in the estimation group (n = 60) and 0.82 (95%CI, 0.69–0.96) in the validation group (n = 56). An NAS score cut-off of 0.396 identified 87.2%of NAS cases in the estimation group, with a PPV of 93.3%; and 75.0%of NAS cases in the validation group, with a PPV of 58.8%. CONCLUSIONS: CEUS examination during the first 4 weeks is useful in assessing the risk of NAS within 1 year after LT. In particular, an NAS score combining the CEUS score, GGT level, and ALT level at week 4 can be used to accurately predict the risk of NAS in LT patients.

scholarly journals Can Tc-99m labeled erythrocyte scintigraphy be an alternative non-invasive method to endometriosis diagnosis?

2017 ◽  
Vol 5 (2) ◽  
pp. 588
Author(s):  
Fatih Demirel ◽  
Gokhan Koca ◽  
Koray Demirel ◽  
Huseyin Aydogmus ◽  
Aylin Akbulut ◽  
...  
Keyword(s):  
Healthy Volunteer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Procedure ◽  
Benign Disease ◽  
Control Group ◽  
Pelvic Mri ◽  
Endometrial Gland ◽  
Non Invasive ◽  
Invasive Method

Background: Endometriosis is defined as the implantation of endometrial gland and stroma ectopically outside the uterus. Clinically, it is a hormone dependent benign disease accompanied by pelvic pain and infertility. The aim of this study was to demonstrate the activated implants with 99m-Tc labeled erythrocyte scintigraphy (99mTc-RBCs) in patients with recurrent endometriosis and compare the results with pelvic MRI results.Methods: Patients who were diagnosed histopathologically as endometriosis either with operation and / or therapeutic laparascopy or laparotomy and, were included to present study. Thirty patients, who were diagnosed as recurrence by clinical, and laboratory terms and 10 healthy volunteer (control group) patients were included in the study. Between the second and fifth days of menstruation when the endometriotic lesions were highly activated, radionuclide imaging was performed by 99mTc-RBCs and compared with pelvic MRI findings.Results: In 27 patients out of 30 patients (90%) pathological accumulation of radioactivity foci with 99mTc-RBCs were present. The focal pathological accumulation was significant in 26 patients and moderate in 1 patient. In 22 patients (81.5%) the increased radioactivity accumulation in radionuclide images was concordant with MRI images. Regarding the MRI as reference, the sensitivity of 99mTc-RBCs was determined as 96%, specificity 29%, positive predicitive value 81% and negative predictive value was 66%.Conclusions: Imaging of endometriosis regions with 99m-Tc-RBCs can be an alternative diagnostic procedure for the patients with recurrent endometriosis.

scholarly journals Use of ultrasonic elastography in the differential diagnosis of pancreatic cystic lesions

2018 ◽  
Vol 17 (3) ◽  
pp. 45-52
Author(s):  
T. V. Dibina ◽  
E. S. Drozdov ◽  
A. P. Koshel ◽  
V. R. Latypov
Keyword(s):  
Differential Diagnosis ◽  
Predictive Value ◽  
Ultrasound Examination ◽  
Mucinous Cystadenoma ◽  
Serous Cystadenoma ◽  
Cystic Lesions ◽  
Transabdominal Ultrasound ◽  
Non Invasive ◽  
Invasive Method ◽  
Sensitivity Specificity

Aim. Evaluate the effectiveness of ultrasonic elastography in the differential diagnosis of pancreatic cystic lesions.Materials and methods. Seventy patients with pancreatic cystic lesions were examined. Structure of clinical forms is the following: cystadenoma – 30 (serous cystadenoma – 23, mucinous cystadenoma – 2, mucinous cystadenocarcinoma – 5), pseudocysts – 40. Diagnosis of pancreatic cystic lesions was conducted with the help of transabdominal ultrasound examination (with 3D-reconstruction) and ultrasonic elastography.Results. The parameters of ultrasonic elastography for various types of pancreatic cystic lesions were determined. Sensitivity, specificity, positive predictive value, negative predictive value, the overall accuracy of the technique accounted for 97, 75, 74, 97 and 84% respectively. The superiority of the elastography technique over the standard transabdominal ultrasound in differential diagnosis of cystic pancreatic formations was illustrated.Conclusions. Ultrasonic elastography is an effective, non-invasive method of differential diagnosis of pancreatic cystic lesions and can be widely used in clinical practice.

Donor evaluation in living related liver transplantation: a new non-invasive method

2002 ◽  
Vol 36 ◽  
pp. 37
Author(s):  
Bernd Frericks ◽  
Franco Calderone ◽  
Andrea Schenk ◽  
Heinz Peitgen ◽  
Bjoern Nashan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Non Invasive ◽  
Donor Evaluation ◽  
Living Related Liver Transplantation ◽  
Invasive Method ◽  
Living Related

scholarly journals Endoscopic Diagnosis of Biliary Stricture Combined with Digital Cholangioscope: A Case Series

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
Seiichiro Fukuhara ◽  
Eisuke Iwasaki ◽  
Atsuto Kayashima ◽  
Yujiro Machida ◽  
Hiroki Tamagawa ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
Biliary Stricture ◽  
Case Series ◽  
Endoscopic Diagnosis ◽  
Biliary Stenosis ◽  
Endoscopic Retrograde ◽  
Non Invasive ◽  
Background Data ◽  
Invasive Method

The endoscopic diagnosis of biliary tract lesions is applied as a non-invasive method; however, its diagnostic accuracy is not yet high. Moreover, digital cholangioscopy is used for directly visualizing the inside of the bile duct, resulting in a more precise biopsy. We present the case series of the outcomes of diagnosis using digital cholangioscopy in patients who underwent cholangioscopy for the evaluation of biliary stenosis in our department between January 2014 and March 2021. The controls were those who underwent a biopsy for biliary stenosis with conventional endoscopic retrograde cholangiopancreatography (ERCP). Background data for each case were collected, and the clinical outcomes by biopsy were evaluated, focusing on the accuracy of the diagnosis. Cholangioscopy was performed in 15 cases, while a conventional biopsy by ERCP was performed in 172 cases. Nine of 15 cases (60.0%) were diagnosed with cholangiocarcinoma. The number of specimens obtained through conventional ERCP and cholangioscopy was 2.5 ± 1.3 and 3.3 ± 1.5, respectively (p = 0.043). The diagnostic accuracy of conventional ERCP and cholangioscopy were 65.7% (113 of 172 cases) and 100%, respectively, which was significantly higher in the group with cholangioscopy. Digital cholangioscopy is useful when the diagnosis of the biliary stricture using the conventional ERCP method is difficult.

A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio

2018 ◽  
Vol 46 (2) ◽  
pp. 219-224 ◽  
Author(s):  
Barış Büke ◽  
Hatice Akkaya
Keyword(s):  
Pulmonary Artery ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Study Cohort ◽  
Ejection Time ◽  
Non Invasive ◽  
Promising Tool ◽  
Fetal Gender ◽  
Invasive Method ◽  
Rule Out

AbstractObjective:To investigate whether fetal pulmonary artery acceleration to ejection time (PATET) ratio can predict or rule out subsequent diagnosis of transient tachypnea of the newborn (TTN).Methods:This prospective cohort study included 105 pregnant women in labor, who met the inclusion criteria. Eighteen of these women were removed from the study cohort, because of an inability to acquire sufficient Doppler waveforms and a longer duration of deliveries. According to subsequent diagnosis of TTN in the neonate, the two groups were constituted, TTN+ and TTN−.Results:There were no statistically significant differences between the groups regarding maternal obstetric and demographic features. The neonatal intensive care unit (NICU) submission rate was significantly higher in the TTN+ group (100%, 17%, P<0.0001, respectively). Regarding the fetal pulmonary artery Doppler findings, PATET ratio in the TTN+ group was significantly lower than the TTN− group (0.307 vs. 0.389, P<0.0001, respectively). The PATET ratio and diagnosis of TTN were inversely correlated (r=−0.41, P<0.001), even if adjusted for birth weight, gestational age and fetal gender (r=0.42, P=0.0021). The cut-off value of 0.319 provided 82.7% specificity, 83.3% sensitivity, 96% negative predictive value and 41.6% positive predictive value. Additionally intraobserver ICC for PATET was found to be 0.86.Conclusion:The fetal PATET ratio seems to serve as a promising tool to rule out subsequent diagnosis of TTN.

Method for diagnosing non-alcoholic liver steatosis

2021 ◽  
Vol 1 (30) ◽  
pp. 53-56
Author(s):  
I. A. Bulatova ◽  
A. M. Miftakhova ◽  
I. L. Gulyaeva
Keyword(s):  
Hepatic Steatosis ◽  
Ultrasound Examination ◽  
Liver Steatosis ◽  
Control Group ◽  
Gamma Glutamyl Transpeptidase ◽  
Non Invasive ◽  
Diagnostic Characteristics ◽  
Invasive Method ◽  
Glutamyl Transpeptidase ◽  
Apparently Healthy

Purpose of the study. Development of a non-invasive method for the diagnosis of non-alcoholic hepatic steatosis.Material and methods. The study involved 21 patients with confrmed non-alcoholic hepatic steatosis on ultrasound examination with an average age of 42.1 ± 10.1 years. The control group consisted of 10 apparently healthy individuals. The following indicators were determined: body mass index (BMI), the level of gamma-glutamyl transpeptidase (GGTP), vasculoendothelial growth factor (VEGF) and interleukin-6 (IL-6) in serum, and the steatosis index (IS) was calculated using the formula IS = –1.2390 + 0.0575 × BMI + 0.0064 × GGTP +0.0006 × VEGF + 0.0001 × IL-6. The index of the presence of hepatic steatosis according to liver ultrasound data was used as a dependent variable.Results. According to the examination results, BMI and serum concentrations of GGTP, VEGF, and IL-6 in patients with steatosis were signifcantly higher than in the control group (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively), which indicates the presence of cholestasis syndrome, signs of inflammation and endothelial dysfunction. The correlation coeffcient between BMI and the presence of non-alcoholic hepatic steatosis was 0.9; between GGTP and the presence of steatosis was 0.80; between VEGF and the presence of steatosis was 0.85; between IL-6 and the presence of steatosis was 0.80. The predictive value of each parameter of the model was assessed using a scale of values of the area under the ROC-curve (AUC). The model is effective (multiple correlation coeffcient R = 0.809; the share of the influence of the sum of the factors included in the model is R2 • 100 = 65.5%), statistically signifcant (criterion F = 12.318; p < 0.0001) and has excellent diagnostic characteristics.Conclusion. The proposed non-invasive method makes it possible to diagnose hepatic steatosis with a sensitivity of 95.2% and a specifcity of 97.0%: with IS equal to 0.5 or more, the presence of non-alcoholic hepatic steatosis is diagnosed, with IS less than 0.5 is not.

Malfunctional Reorganization in the Developing Limbo-Prefrontal System in Animals: Implications for Human Psychoses?

2001 ◽  
Vol 12 (1) ◽  
pp. 8-14
Author(s):  
Gertraud Teuchert-Noodt ◽  
Ralf R. Dawirs
Keyword(s):  
Prefrontal Cortex ◽  
Mental Disorders ◽  
Dentate Gyrus ◽  
Cognitive Functions ◽  
Experimental Approach ◽  
Regulatory Mechanisms ◽  
Hippocampal Dentate Gyrus ◽  
Non Invasive ◽  
Invasive Method ◽  
Activity Dependent

Abstract: Neuroplasticity research in connection with mental disorders has recently bridged the gap between basic neurobiology and applied neuropsychology. A non-invasive method in the gerbil (Meriones unguiculus) - the restricted versus enriched breading and the systemically applied single methamphetamine dose - offers an experimental approach to investigate psychoses. Acts of intervening affirm an activity dependent malfunctional reorganization in the prefrontal cortex and in the hippocampal dentate gyrus and reveal the dopamine position as being critical for the disruption of interactions between the areas concerned. From the extent of plasticity effects the probability and risk of psycho-cognitive development may be derived. Advance may be expected from insights into regulatory mechanisms of neurogenesis in the hippocampal dentate gyrus which is obviously to meet the necessary requirements to promote psycho-cognitive functions/malfunctions via the limbo-prefrontal circuit.

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Strain Gauge ◽  
Predictive Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Deep Vein

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

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