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Hepatosteatoz Olgularında Elastografi Bulguları

Year 2014, Volume: 15 Issue: 3, 85 - 89, 01.12.2014

Abstract

AMAÇ: Bu çalışma alkolik olmayan yağlı karaciğer (NAFLD) olgularının biopsi öncesi değerlendiriminde elastografinin etkinliğini araştırmak için planlandı.GEREÇ VE YÖNTEMLER: Radyoloji bölümünde 18 NAFLD hastası B mod ultrason ile incelendikten sonra elastografi ile değerlendirildi . Olguların hiçbirinde kronik karaciğer hastalığı yoktu. Yaşları 35 ila 71 arasında değişen 8 erkek hasta ile 10 kadın hasta çalışmaya dahil edildi ( ortalama 54±9.5). Son 6 ay içerisindeki biyokimyasal değerlendirmeleri de kayıt altına alındı. Karaciğer dalak ile karşılaştırılarak ekojenite artışına göre I., II. ve III. derecelerde ile sınıflandıırldı. B mod ve elastografi değerlendirilmesi Hitachi HI VISION Preirus sistemi ile 6.5 MHz lineer prob ile yapıldı. BULGULAR: Olguların %55,6’sı kadın, %44’ ü erkek idi. Evre I NAFLD olgularının tümü kadın idi (n:5). Evre III olgularının sadece %33,3’ü kadın idi (n:2). Gruplar arası hepatosteatoz evresi göz önüne alındığında elastografi sonuçları arasında fark saptanmadı. Biyokimyasal değerler ve hepatomegali ölçüm değerleri göz önüne alındığında GGT ve hepatomegali ölçümleri gruplar arası farklılık göstermekte idi (p:0.015). SONUÇ: Bu çalışmada, B mod ultrasonda sıklıkla kullanılan hepatosteatoz evreleme sistemi elastografi tekniği ile doğrulanamadı. Böylelikle NAFLD tanısı ile biyopsi gereken ile gerekmeyen takipteki olgular arasında ayrım yapılamadı. Bu veri transient elastografi bulgularından oldukça farklı idi

References

  • 1. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346: 1221- 31. [CrossRef]
  • 2. Ludwig J, Viggiano TR, McGill DB, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980; 55: 434-8.
  • 3. Liou I, Kowdley KV. Natural history of nonalcoholic steatohepatitis. J Clin Gastroenterol 2006; 40 Suppl 1: S11-6.
  • 4. Mori S, Yamasaki T, Sakaida I, et al. Hepatocellular carcinoma with nonalcoholic steatohepatitis. J Gastroenterol 2004; 39: 391-6. [CrossRef]
  • 5. Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 1999; 30: 1356-62. [CrossRef]
  • 6. Abenavoli L, Corpechot C, Poupon R. Elastography in hepatology. Can J Gastroenterol 2007; 21: 839-42.
  • 7. Regev A, Berho M, Jeffers LJ, et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 2002; 97: 2614-8. [CrossRef]
  • 8. Abenavoli L, Beaugrand M. Transient elastography in non-alcoholic fatty liver disease. Ann Hepatol 2012; 11: 172-8.
  • 9. Arda K, Ciledag N, Aribas BK, Aktas E, Kose K. Quantitative assessment of the elasticity values of liver with shear wave ultrasonographic elastography. Indian J Med Res 2013; 137: 911-5.
  • 10. Yoneda M, Fujita K, Inamori M, et al. Transient elastography in patients with non-alcoholic fatty liver disease (NAFLD). Gut 2007; 56: 1330-1. [CrossRef]
  • 11. Yoneda M, Mawatari H, Fujita K, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Dig Liver Dis 2008; 40: 371-8. [CrossRef]
  • 12. Gheonea DI, Saftoiu A, Ciurea T, et al. Real-time sono-elastography in the diagnosis of diffuse liver diseases. World J Gastroenterol 2010; 16: 1720- 6. [CrossRef]
  • 13. Cui XW, Friedrich-Rust M, Molo CD, Ignee A, Schreiber-Dietrich D, Dietrich CF. Liver elastography, comments on EFSUMB elastography guidelines 2013. World J Gastroenterol 2013; 19: 6329-47. [CrossRef]
  • 14. Argo CK, Northup PG, Al-Osaimi AM, Caldwell SH. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol 2009; 51: 371-9. [CrossRef]
  • 15. Suzuki K, Yoneda M, Imajo K, et al. Transient elastography for monitoring the fibrosis of non-alcoholic fatty liver disease for 4 years. Hepatol Res 2013; 43: 979-83. [CrossRef]
  • 16. Petta S, Di Marco V, Camma C, Butera G, Cabibi D, Craxi A. Reliability of liver stiffness measurement in non-alcoholic fatty liver disease: the effects of body mass index. Aliment Pharmacol Ther 2011; 33: 1350-60. [CrossRef]
  • 17. Wong VW, Vergniol J, Wong GL, et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010; 51: 454-62. [CrossRef]
  • 18. Lupsor M, Badea R, Stefanescu H, et al. Performance of unidimensional transient elastography in staging non-alcoholic steatohepatitis. J Gastrointestin Liver Dis 2010; 19: 53-60.

Ultrasound Elastography Findings in Patients with NAFLD

Year 2014, Volume: 15 Issue: 3, 85 - 89, 01.12.2014

Abstract

OBJECTIVE: This study evaluates whether dynamic elastography could better characterize and differentiate the non-alcoholic fatty liver disease (NAFLD) and patient pool for biopsy. MATERIALS AND METHODS: 18 patients with NAFLD were examined by ultrasound (US) and elastography at the Department of Radiology. The patients, none of whom had any chronic liver disease, were 54±9.5 (35-71) years old (8 men; 10 women). Biochemical markers were evaluated. Patients with high liver echogenicity were classified as Stage III NAFLD. B-mode US equipment includes a Hitachi HI VISION Preirus system with an embedded elastography (EL) module (Hitachi Medical Systems Europe) and 6.5 MHz linear probe. RESULTS: Of the cases, 55.6% were female and 44.4% were male. All cases with Stage I NAFLD were female (n:5). Only 33.3% of the cases with Stage III NAFLD were female (n:2). According to the results of elastography, no intergroup difference was differentiated when the stages of NAFLD were compared. When biochemical and hepatomegaly values were considered, differences were only detected in GGT and hepatomegaly values among the NAFLD groups (p:0.015). CONCLUSION: In the study, the stages of hepatosteatosis could not be differentiated with the EL examination. Therefore, it was thought to be of no benefit to the selection.

References

  • 1. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346: 1221- 31. [CrossRef]
  • 2. Ludwig J, Viggiano TR, McGill DB, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980; 55: 434-8.
  • 3. Liou I, Kowdley KV. Natural history of nonalcoholic steatohepatitis. J Clin Gastroenterol 2006; 40 Suppl 1: S11-6.
  • 4. Mori S, Yamasaki T, Sakaida I, et al. Hepatocellular carcinoma with nonalcoholic steatohepatitis. J Gastroenterol 2004; 39: 391-6. [CrossRef]
  • 5. Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 1999; 30: 1356-62. [CrossRef]
  • 6. Abenavoli L, Corpechot C, Poupon R. Elastography in hepatology. Can J Gastroenterol 2007; 21: 839-42.
  • 7. Regev A, Berho M, Jeffers LJ, et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 2002; 97: 2614-8. [CrossRef]
  • 8. Abenavoli L, Beaugrand M. Transient elastography in non-alcoholic fatty liver disease. Ann Hepatol 2012; 11: 172-8.
  • 9. Arda K, Ciledag N, Aribas BK, Aktas E, Kose K. Quantitative assessment of the elasticity values of liver with shear wave ultrasonographic elastography. Indian J Med Res 2013; 137: 911-5.
  • 10. Yoneda M, Fujita K, Inamori M, et al. Transient elastography in patients with non-alcoholic fatty liver disease (NAFLD). Gut 2007; 56: 1330-1. [CrossRef]
  • 11. Yoneda M, Mawatari H, Fujita K, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Dig Liver Dis 2008; 40: 371-8. [CrossRef]
  • 12. Gheonea DI, Saftoiu A, Ciurea T, et al. Real-time sono-elastography in the diagnosis of diffuse liver diseases. World J Gastroenterol 2010; 16: 1720- 6. [CrossRef]
  • 13. Cui XW, Friedrich-Rust M, Molo CD, Ignee A, Schreiber-Dietrich D, Dietrich CF. Liver elastography, comments on EFSUMB elastography guidelines 2013. World J Gastroenterol 2013; 19: 6329-47. [CrossRef]
  • 14. Argo CK, Northup PG, Al-Osaimi AM, Caldwell SH. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol 2009; 51: 371-9. [CrossRef]
  • 15. Suzuki K, Yoneda M, Imajo K, et al. Transient elastography for monitoring the fibrosis of non-alcoholic fatty liver disease for 4 years. Hepatol Res 2013; 43: 979-83. [CrossRef]
  • 16. Petta S, Di Marco V, Camma C, Butera G, Cabibi D, Craxi A. Reliability of liver stiffness measurement in non-alcoholic fatty liver disease: the effects of body mass index. Aliment Pharmacol Ther 2011; 33: 1350-60. [CrossRef]
  • 17. Wong VW, Vergniol J, Wong GL, et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010; 51: 454-62. [CrossRef]
  • 18. Lupsor M, Badea R, Stefanescu H, et al. Performance of unidimensional transient elastography in staging non-alcoholic steatohepatitis. J Gastrointestin Liver Dis 2010; 19: 53-60.
There are 18 citations in total.

Details

Other ID JA94VY95EJ
Journal Section Research Article
Authors

Özüm Tunçyürek This is me

M. Onur Türkkan This is me

Nalan Mirzai This is me

Uğur Açıkalın This is me

Pars Tunçyürek This is me

Publication Date December 1, 2014
Published in Issue Year 2014 Volume: 15 Issue: 3

Cite

EndNote Tunçyürek Ö, Türkkan MO, Mirzai N, Açıkalın U, Tunçyürek P (December 1, 2014) Ultrasound Elastography Findings in Patients with NAFLD. Meandros Medical And Dental Journal 15 3 85–89.