RESUMEN
Liver stiffness measurement (LSM) has been widely used in predicting portal hypertension in clinical practice, and in recent years, spleen stiffness measurement (SSM) has also become a diagnostic tool. Studies have shown that SSM can predict portal hypertension and its complications such as esophagogastric variceal bleeding in patients with chronic liver diseases and assist in the risk stratification management of portal hypertension and esophagogastric variceal bleeding. It can accurately predict clinically significant portal hypertension, high-risk esophageal and gastric varices, decompensation rate, and mortality rate in patients with chronic liver diseases. At present, SSM data in most studies are obtained by detection using the liver equipment FibroScan Ⓡ (SSM@50 Hz). FibroScan Ⓡ 630 is a new scanner dedicated for SSM with a special mode for SSM (SSM@100 Hz). This article elaborates on the significance of SSM in predicting portal hypertension and briefly introduces the advantages and disadvantages of the new equipment for SSM.
RESUMEN
Objective To investigate the correlation between the stage of hepatic fibrosis and the diameter of portal vein (DPV) and middle hepatic vein (DMHV) in patients with chronic hepatitis B.Methods 320 patients with chronic hepatitis B were evaluated by ultrasonography.The DPV and DMHV were measured,and their correlation with the degree of hepatic fibrosis was analyzed after liver biopsy.Results DPV was positively related with the degree of hepatic fibrosis(r =0.384,P =0.032),while DMHV was negatively related with the degree of hepatic fibrosis (r =-0.521,P =0.015).The DPV and HMDV in S4 were bigger than those of S0,S1,S2 and S3,and statistical differences existed among them (DPV∶z =0.334,P =0.032 ; DMH∶z =0.161,P =0.015).The best value of S4 diagnosing by DPV was 13mm.The best value of S4 diagnosing by DMHV was 6mm.The area under the curve of ROC for DPV and DMHV in ≥S2 was 0.753 and 0.758 respectively.It in≥S3 was 0.795 and 0.802 respectively.It in ≥S4 was 0.797 and 0.828 respectively.The area under the curve of ROC for combination of DPV and HMDV was 0.866,which was higher than that of DPV and HMDV.Conclusion There is a good correlation between DPV,DMHV and the stage of hepatic fibrosis in patients with chronic hepatitis B.Combination of DPV and HMDV has clinical significance for diagnosing early hepatic fibrosis.
RESUMEN
Objective To investigate the efficacy of ICG clearance test for hepatic reserve function in patients with hepatic cirrhosis and primary liver carcinoma by pulse dye deusitometry (PDD). Methods Eighty-nine patients with hepatic cirrhosis and forty patients with primary hver carcinoma were enrolled in this study. All patients were classified by Child-Pugh grade. The value of indocyanin green retention at 15 min (ICGRI5) was measured by PDD. Biochemical parameters including CHE, PAB, ALB, PTA and TBA were also examined. Correlation analysis between ICGR15 and those indexes were conducted. Results (1) ICGR15, CHE, TBA, ALB, PTA among Child-Pugh A, B, C in all patients were significantly different (P < 0.05). PAB between Child-Pugh B and A group, C and B group was significantly different (P < 0.05). (2)Increased level of ICGR15 and TBA positively correlated with Child-Pugh scores, while negatively correlated with the level of PTA. The difference of ICGRI5 between Child-Pugh score 5 and score 7, score 9 and score 10 were all significant (P <0.05). (3) The correlation between ICGR15 and other clinical markers is significant. The clinical marker with the best correlation was TBA (r=0.605), was the parameter in most significantly correlated with ICGR15 followed by PTA, CHE, PAB, and ALB (r= -0.598, -0.565, -0.537, -0.424). Conclusion There was good correlation between the clinical markers and the value of ICGR15 which demonstrate superiority to the other indexes. The data also suggested that CHE, TBA, could be used in evaluating liver reserve function.