Population screening for cirrhosis

Hepatology Communications, Год журнала: 2024, Номер 8(9)

Опубликована: Авг. 26, 2024

In response to the growing health crisis of liver-related morbidity and mortality, screening for liver cirrhosis has emerged as a promising strategy early detection timely intervention. By identifying individuals with severe fibrosis or compensated cirrhosis, holds promise enhancing treatment outcomes, delaying disease progression, ultimately improving quality life affected individuals. Clinical practice guidelines from international scientific societies currently recommend targeted strategies, investigating high-risk populations known risk factors disease. While there is good evidence that increases case finding in population, number studies indicate may motivate beneficial lifestyle changes patients steatotic disease, are major gaps knowledge need clarification before programs implemented. Foremost, randomized trials needed ensure leads improved mortality. If not, could be unethical due overdiagnosis, overtreatment, increased care costs, negative psychological consequences screening, futile invasive investigations. Moreover, tests used optimized toward lower false positive rates than FIB-4 while retaining few negatives. Finally, barriers adherence implementation elucidated. This review provides comprehensive overview current landscape strategies promises pitfalls methods detection.

Язык: Английский

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Portal Hypertension—Noninvasive Multiparametric Ultrasound‐Based Criteria and Measurements

Portal hypertension & cirrhosis, Год журнала: 2025, Номер unknown

Опубликована: Март 17, 2025

ABSTRACT Portal hypertension, the most common complication in liver cirrhosis, is characterized by a pathologic increase portal venous pressure. hypertension defined as pressure gradient greater than 5 mmHg between vein and inferior caval vein. Clinically significant determined hepatic (HVPG) exceeding 10 mmHg. Complications are likely to occur if exceeds this threshold. The gold standard for assessing measurement of HVPG, which an invasive procedure. This review discusses various multiparametric capabilities ultrasound, including B‐mode, color Doppler imaging, measurement, contrast‐enhanced endoscopic elastography diagnose assess its severity.

Язык: Английский

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Ultrasound backscatter coefficient for fat quantification is affected by the measurement depth

Abdominal Radiology, Год журнала: 2024, Номер unknown

Опубликована: Июнь 4, 2024

Язык: Английский

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A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(19), С. 5880 - 5880

Опубликована: Окт. 2, 2024

Background and Objectives: Metabolic syndrome (MetS) is a condition marked by complex array of physiological, biochemical, metabolic abnormalities, including central obesity, insulin resistance, high blood pressure, dyslipidemia (characterized elevated triglycerides reduced levels high-density lipoproteins). The pathogenesis develops from the accumulation lipid droplets in hepatocyte (steatosis). This accumulation, genetically predisposed subjects with other external stimuli (intestinal dysbiosis, caloric diet, physical inactivity, stress), activates production pro-inflammatory molecules, alter autophagy, turn on activity hepatic stellate cells (HSCs), provoking low grade chronic inflammation fibrosis. associated significantly increased risk developing type 2 diabetes mellitus (T2D), cardiovascular diseases (CVD), vascular, renal, pneumologic, rheumatological, sexual, cutaneous syndromes overall mortality, rising five- to seven-fold for T2DM, three-fold CVD, one half–fold all-cause mortality. purpose this narrative review examine as “systemic disease” its interaction major internal medicine conditions such diabetes, renal failure, respiratory failure. It essential practitioners approach widespread “holistic” rather than fragmented manner, particularly Western countries. Additionally, it important be aware non-invasive tools available assessing condition. Materials Methods: We conducted an exhaustive search PubMed up July 2024, focusing terms related pathologies (heart, Lung (COPD, asthma, pulmonary hypertension, OSAS) kidney rheumatological (osteoarthritis, rheumatoid arthritis), endocrinological, sexual neoplastic risks. was managed accordance PRISMA statement. Finally, we selected 300 studies (233 papers first strategy 67 second one). Our included that provided insights into techniques evaluating liver fibrosis steatosis. Studies were not humans, published languages English, or did assess changes heart failure excluded. Results: findings revealed clear correlation between all above described, indicating assessments steatosis could potentially serve markers severity progression diseases. Conclusions: multisystem disorder impacts organs beyond disrupts functioning various organs. Notably, linked higher incidence diseases, independent traditional factors. Non-invasive allow clinicians evaluate risk. ability may open new diagnostic, therapeutic, prognostic avenues managing complications, disease, which leading cause death these patients.

Язык: Английский

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Twin Peak Method for Estimating Tissue Viscoelasticity Using Shear Wave Elastography

Ultrasound in Medicine & Biology, Год журнала: 2025, Номер unknown

Опубликована: Май 1, 2025

Язык: Английский

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Liver Elastography for Liver Fibrosis Stratification: A Comparison of Three Techniques in a Biopsy-Controlled MASLD Cohort

Biomedicines, Год журнала: 2025, Номер 13(1), С. 138 - 138

Опубликована: Янв. 9, 2025

Background: The aim of this study was to investigate the accuracy in fibrosis staging a novel shear wave elastography (SWE) device (S-Shearwave Imaging by Samsung) and previously validated 2D-SWE Supersonic Imagine (SSI) patients with biopsy proven metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: This prospective included 75 consecutive MASLD who underwent for suspected MASH. All S-Shearwave Samsung SSI on same day biopsy. Fibrosis histologically assessed using METAVIR classification system. Agreement between equipment Pearson coefficient. A receiver operator characteristic curve (ROC) analysis Youden index used establish thresholds staging. Results: good correlation found (Pearson's R = 0.68; p < 0.01). At multivariate regression analysis, associated advanced (≥F3) independently from age, diabetes platelets (OR 2.94, CI 1.69-5.11, diagnostic both optimal AUROCs 0.81 0.70 significant (≥F2), 0.94 0.91 severe (≥F3), respectively. is not significantly different Fibroscan Agile3+ (DeLong test value 0.16 0.15, respectively) while slightly better than 2D-SWE, FIB4 NFS 0.05). For Samsung, best cut-off values diagnosing ≥F2, ≥F3 were, respectively, 7.9 kPa (Sens 74.4%, Spec 87.5%) 8.1 95.6%, 78.8%). SSI, 7.2 55.8%, 84.4%) 7.6 82.6%, 84.6%). Conclusion: useful reliable non-invasive technique MASLD. Its non-inferior other techniques (TE SSI).

Язык: Английский

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Shear wave elastography primer for the abdominal radiologist

Abdominal Radiology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 30, 2025

Язык: Английский

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MPUS is a big step forward for small organs

Ultraschall in der Medizin - European Journal of Ultrasound, Год журнала: 2025, Номер 46(01), С. 8 - 13

Опубликована: Фев. 1, 2025

Multiparametric imaging combines the information from different functional sequences or techniques and is best known multiparametric MRI in which of a number used to investigate lesions. By combining analysis several structural tissue properties, characterization lesions much more precise than by just relying on one sequence technique only. In fact, combination variety procedures as "one-shop" procedure resulted term "multiparametric". daily clinical practice neuroimaging, liver imaging, musculoskeletal breast prostate etc. The 'multiparametric' can also be applied computed tomography (CT) it allows 3D-reconstruction at phases after contrast administration. CT has improved visualization chest, pleural abdominal cavity revolutionized trauma management plays fundamental role diagnosis acute abdomen. Despite undisputed strengths CT, limitations are obvious: radiation exposure, foreign bodies with contraindication for MRI, patient movement without injection media, high cost availability and, above all, impossibity us bedside directly "at point need", claustrophobia significant proportion patients, sedation pediatric use others [1] [2]. recent decades, ultrasound outgrown one-dimensionality A-Mode frequency-dependent high-resolution morphological details B-Mode ways: processes mapped real time, displayed 4 D, interaction structures propagation characteristics sound waves qualitative quantitative elasticity strain shear wave elastography, fat infiltration attenuation potentially necro-inflammation using dispersion. Doppler contrast-enhanced quantitatively capture blood flow, vascular density vascularization patterns their surroundings real-time – highest temporal spatial resolution [3] [4] [5] [6]. This multitude properties achieved lower costs morbidity any other modality. since first 'multiparametric ultrasound' (MPUS) [7], years popularity was gained literature among scientific societies active field medical its describe modern various technologies precisely characterize focal surrounding parenchyma features, perhaps similar terminology [8]. Since foundation, European Federation Societies Ultrasound Medicine Biology (EFSUMB) established strong tradition supporting good promoting evidence-based medicine [9] [10]. Considering utility those newer techniques, EFSUMB published guidelines, technical reviews, position papers many areas including CEUS [11] [12] [13] [14], time intensity curves [15], elastographic [6], but interventional [16] [17] [18] [19] [20] [21] [22] [23] [24] gastrointestinal [25] [26] [27] [28] [29] [30]. light increasing publications need analyse benefits limitations, well standardize (MPUS), decided launch MPUS guidelines "small parts" (thyroid, testis, breast) proceed pancreatic application MPUS. Guidelines have already been World (WFUMB) close cooperation [31] [32].

Язык: Английский

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Impact of shear wave elastography and attenuation imaging for predicting life-threatening event in patients with metabolic dysfunction-associated steatotic liver disease

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Фев. 7, 2025

We aimed to elucidate the value of ultrasound-based biomarkers for predicting major life-threatening events in metabolic dysfunction-associated steatotic liver disease (MASLD). established a prospective cohort 279 patients who underwent two-dimensional shear wave elastography (2D-SWE), ultrasound-guided attenuation parameter (UGAP). An area under curve analysis was performed determine cutoff values stiffness measurements (LSM) by 2D-SWE and coefficient (AC) UGAP moderate fibrosis steatosis. then classified into Groups A (low LSM low AC), B high C (high D AC). compared incidence between groups, estimated hazard ratios (HRs) with 95% confidence intervals (CIs). The AC cut off were 8.37 kPa 0.62 dB/cm/MHz, respectively. cumulative rate A, B, C, 11.2%, 12.2%, 29.5%, 31.0%/5years, respectively (p < 0.05). (HRs = 1.20, 95%CIs: 1.09–1.32, p 0.01), 1.62, 1.04–2.51, 0.03) associated events. combination may help identify MASLD at risk subsequent

Язык: Английский

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Shear-Wave Dispersion Slope (SWDS) is a new ultrasound parameter to detect liver inflammation

Medical Visualization, Год журнала: 2025, Номер 29(1), С. 41 - 50

Опубликована: Фев. 12, 2025

Background: one of the most pressing problems ultrasound shear wave elastometry liver is lack distinct digital differential diagnostic criteria for presence and severity fibrosis in inflammation. Purpose. To evaluate possibility a new ultrasonic parameter – dispersion slope (SWDS) solving this problem. Materials methods . 156 patients with various pathologies were examined. Depending on absence or fibrosis, as well inflammatory changes (according to biopsy serological blood tests), examined divided into three groups. The control group consisted 10 healthy donors. Measurements velocity (SWS), assessment attenuation (ATI) performed using Canon Medical Aplio i800 system (Tokyo, Japan) standard convex transducer. Results indicators SWS, SWDS ATI (Median 95% CI) Me 1.2 (95% CI 1.1–1.6) m/s, 10.1 9.7–14.3) m/s/kHz 0.54 0.41–0.63) dB/cm/MHz, respectively. study main showed that there close correlation between SWS (Spearman's rho = 0.74). At same time, subgroup inflammation had significantly (p < 0.01) higher values compared without 16.4 15.3–17.9) versus 12.7 (95%CI 12.1–14.3) m/s/kHz. In but inflammation, was also significant increase from 12,0 11.4–12.8) at F0-1 16,5 12.9–20.3) F3–4 METAVIR. Conclusion. use absolute did not contribute achievement purpose detection diagnosis hepatitis. Nevertheless, results provide grounds making fairly confident conclusion relationship binary logistic regression formula ( logit(p) 0, 4152 м / с кГц ) 0,1344 6,5115) can become valuable additional method diagnostics liver.

Язык: Английский

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