ABSTRACT
Objective To evaluate the clinical significance of acoustic radiation force impulse ( ARFI) technique in the assessment of non-surgical complications after liver transplantation . Methods Three hundred and seventy-two patients with abnormal liver function after liver transplantation undergone ARFI exam before liver biopsy ( excluding surgical complications) . The shear wave velocity ( SWV ) between different groups divided according pathological results after biopsy was compared ,and SWV of 23 patients with normal liver function after liver transplantation was compared too . Moreover , 26 normal people were random selected as control group . Results ① Among the 372 patients ,there were 100 cases of rejection ,82 cases of biliary complications ,52 cases of hepatitis virus infection ,49 cases of drug induced liver injury ,56 cases of non-specific manifestation ,9 cases of steatosis ,3 cases of hypoxic-ischemic ,2 cases of inappropriate preserve injury and 19 cases of diagnosis were not clear . ② SWV of control group was ( 1 .49 ± 0 .66) m/s ,of normal liver function group was ( 1 .64 ± 0 .68) m/s ,of abnormal liver function group was ( 2 .08 ± 0 .66) m /s . Abnormal liver function group had higher SWV than normal liver function group and control group ( P < 0 .01) . There was no significant difference between normal liver function group and control group ( P > 0 .05) . ③ In the specific pathology manifestation patients ,hepatitis virus infection group had the highest SWV[ ( 2 .29 ± 0 .72) m /s] ,drug induced liver injury group had the lowest SWV [ ( 1 .94 ± 0 .57) m /s] ,and there were significant differences between two groups ( P < 0 .01) . ④ The ROC results showed that the area under curve of ARFI was 0 .688 for patients with abnormal liver function after liver transplantation , and 0 .655 for differential diagnosis between drug induced liver injury and hepatitis virus infection .Conclusions As a noninvasive technique ,ARFI is correlated with histopathology and has clinical value in the differential diagnosis of non-surgical complications after transplantation .
ABSTRACT
Objective To investigate the value of ultrasound multiplex mode in the evaluation ot liver damage caused by brain death.Methods Brain death model were established in 12 Ba-Ma pigs by gradual intracranial compression method.Color Doppler flow imaging (CDFI),contrast-enhanced ultrasonography (CEUS) and real-time elastography (RTE) were performed respectively before the model had been established which defined as control group,and at 0 h,3 h,6 h,9 h after brain death,the data were analyzed.According to the pathological changes of liver,the livers were divided into different groups for ROC curve analysis,and the effectiveness of single mode ultrasound and multiplex were compared.Results ①Compared with control group,velocity of portal vein (PVV) decreased,and resistance index(RI),hepatic artery systolic velocity/diastolic velocity (S/D),pulsatility index (PI) increased in experimental group (all P ＜ 0.05);arrival time of the hepatic artery(ATHA),arrival time of the portal vein(ATPV) and arrival time of the inferior vena cava(ATIVC) increased with the extension of brain death time (all P ＜0.05);mean value (MEAN),standard deviation(SD) of the relative strain value within the ROI,area of low strain within the ROI (％ AREA),complexity of low strain area within the ROI (COMP),skewness (SKEW),correlation(CORR) were significant different between experimental group and control group (all P ＜0.05).②RI,ATHA and MEAN demonstrated the highest diagnostic accuracy (AUC =0.518,0.833,0.917) among CDFI,CEUS and RTE indexes.③Combined with ATHA and MEAN had the highest effectiveness in ultrasound multiplex mode to evaluate liver injury caused by brain death.Conclusions Ultrasound multiplex mode combining CEUS and RTE in evaluation of liver injury caused by brain death has higher sensitivity and accuracy.