Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnosis , Liver Cirrhosis/complications , Liver Cirrhosis/diagnosis , Heparin/therapeutic use , Ethanol/adverse effects , Thrombosis/complications , Thrombosis , Carcinoma, Hepatocellular/physiopathology , Carcinoma, HepatocellularABSTRACT
OBJECTIVES: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US). MATERIAL AND METHODS: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. RESULTS: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. CONCLUSIONS: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.
Subject(s)
Contrast Media , Phospholipids , Polysaccharides/therapeutic use , Sulfur Hexafluoride , Ultrasonography, Doppler, Color/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , Spain , Young AdultABSTRACT
To evaluate the utility of fibrinogen as a prognostic factor in acute pancreatitis (PA) it was measured within 48 hours of admission in 55 patients with acute pancreatitis studied prospectively. We found that patients with fibrinogen levels above 850 mg/dl. presented a serious evolution in 55.55% of cases as compared to 10.87% of those who had levels below this figure (p less than 0.01). We conclude that fibrinogen measurement can be useful in the early evaluation of the prognosis of acute pancreatitis.
