ABSTRACT
BACKGROUND The aim of this study was to investigate the usefulness of contrast-enhanced ultrasonography (CEUS) in predicting of esophageal varices (EV) and assessing high-risk EV in patients with hepatitis B virus (HBV)-related cirrhosis. MATERIAL AND METHODS Patients with HBV-related cirrhosis who had undergone endoscopy were prospectively recruited. Hepatic dynamic CEUS was performed. Regions of interest (ROI) were drawn on the hepatic artery, hepatic vein, portal vein, and liver parenchyma to measure the corresponding features, such as arrival times. Spearman's correlation analysis was used to determine the relations between several dynamic CEUS features and the degree of EV. Receiver operating characteristics (ROC) curves were constructed to investigate the diagnostic performance of CEUS in assessing the presence of EV and high-risk EV. RESULTS Fifty-eight patients (44 men; mean age 51.3 years) were included in this study. Of these, 18 (31.0%), 12 (20.7%), 11 (19.0%), and 17 (29.3%) of patients had grade 0, 1, 2, and 3 EV, respectively. Grade 2 and grade 3 EV were considered high-risk EV. Among the CEUS features, the area under the ROC curves of intrahepatic transit time (HV-HA, i.e., the difference between hepatic vein arrival time and hepatic artery arrival time) both for assessment of the presence of EV and high-risk EV (0.883 and 0.915, respectively) were larger than the other indices. HV-HA was negatively correlated with the grade of EV. An HV-HA of under 8.2 s indicated the presence of EV and under 7 s indicated high-risk EV. CONCLUSIONS Dynamic CEUS imaging is useful in assessing the presence of EV and high-risk EV in patients with HBV-related cirrhosis.
Subject(s)
Contrast Media/chemistry , Esophageal and Gastric Varices/diagnostic imaging , Esophageal and Gastric Varices/virology , Hepatitis B virus/physiology , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/virology , Ultrasonography , Adult , Esophageal and Gastric Varices/complications , Female , Humans , Liver Cirrhosis/complications , Male , Middle Aged , ROC Curve , Risk Factors , SoftwareABSTRACT
OBJECTIVES: The purpose of this study was to assess the diagnostic performance of ultrasound-guided diffuse optical tomography for differentiation of benign and malignant breast lesions. METHODS: The Cochrane Library, PubMed, and Embase databases were searched from inception to February 14, 2016. Sensitivity, specificity, and other information were extracted from the included studies. Sensitivity and specificity were pooled by a bivariate mixed-effects binary regression model. A summary receiver operating characteristic curve was constructed. Heterogeneity and publication bias were explored by Higgins and Deeks tests, respectively. RESULTS: Seven studies including 768 women with 886 lesions were analyzed. The summary sensitivity, specificity, and diagnostic odds ratio were 95% (95% confidence interval [CI], 85%-98%), 77% (95% CI, 66%-85%), and 57 (95% CI, 12-267), respectively. The area under the summary receiver operating characteristic curve was 91% (95% CI, 89%-94%). No significant heterogeneity or publication bias existed. CONCLUSIONS: Ultrasound-guided diffuse optical tomography is useful for differentiating breast lesions. Especially, its sensitivity is excellent.
Subject(s)
Breast Neoplasms/diagnostic imaging , Tomography, Optical/methods , Ultrasonography, Mammary/methods , Breast/diagnostic imaging , Diagnosis, Differential , Female , Humans , Sensitivity and SpecificityABSTRACT
OBJECTIVES: The purpose of this study was to assess the performance of SuperSonic shear imaging (SuperSonic Imagine SA, Aix-en-Provence, France) for diagnosis of liver fibrosis. METHODS: Literature databases were searched to identify relevant studies from inception to February 28, 2015. Sensitivity, specificity, and other information were extracted from the studies. Pooled data were calculated by a bivariate mixed-effects binary regression model. Subgroup and sensitivity analyses were performed. Publication bias was tested by funnel plots. RESULTS: Twelve studies were included in this meta-analysis and reported on 1635 patients. The pooled sensitivity and specificity were 0.78 (95% confidence interval [CI], 0.69-0.85) and 0.95 (95% CI, 0.75-0.99), respectively, for fibrosis stages F≥1, 0.84 (95% CI, 0.81-0.86) and 0.81 (95% CI, 0.74-0.87) for F≥2, 0.89 (95% CI, 0.85-0.93) and 0.84 (95% CI, 0.77-0.89) for F≥3, and 0.88 (95% CI, 0.82-0.91) and 0.86 (95% CI, 0.81-0.90) for F=4. The areas under the summary receiver operating characteristic curves were 0.87 (95% CI, 0.84-0.90) for F≥1, 0.85 (95% CI, 0.81-0.88) for F≥2, 0.93 (95% CI, 0.91-0.95) for F≥3, and 0.93 (95% CI, 0.90-0.95) for F=4. No significant publication bias was found. CONCLUSIONS: SuperSonic shear imaging could be used for staging of liver fibrosis. Especially, it has high diagnostic accuracy for severe fibrosis and cirrhosis.
