Comparison of size of the liver between patients with non-alcoholic fatty liver disease and healthy controls.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease across all age groups. Limited studies have been conducted to consider the relationship between NAFLD and liver size. This study aimed to compare the size of the liver between NAFLD patients and healthy controls. Methods: This case-control study was conducted on NAFLD patients (n = 300), and healthy subjects (n = 300) referred to the Golestan Hospital of Ahvaz from April to August 2021. All individuals underwent ultrasonography examination, and liver size was measured in the midclavicular line. Fatty liver was divided into three grades, I (mild), II (moderate), and III (severe), according to the disease severity. Anthropometric parameters, including age, sex, weight, height, and body mass index (BMI), were recorded. Finally, the size of the liver and its relationship with NAFLD and anthropometric parameters was evaluated. Results: Patients had significantly higher weight, and BMI mean values than controls (P < 0.001). In comparison to controls, NAFLD patients had considerably larger livers on average. (149.05 ± 12.60 mm vs. 134.51 ± 12.09; P < 0.001). There was a significant tendency for larger liver size in normal to severe fatty liver patients (P < 0.001). In patients with mild, moderate, and severe NAFLD, the mean liver size was 144.34 ± 11.35, 154.21 ± 10.84, and 158.63 ± 13.45 mm, respectively. The mean liver size in both groups was significantly higher in males than females (P < 0.05). Age (P = 0.037), sex (P < 0.001), height (P < 0.001), BMI (P = 0.008), and steatosis (P < 0.001) were independent variables for predicting the liver size. Conclusion: The liver size of persons with fatty liver was substantially more considerable than healthy people. The size of the liver was substantially linked with sex, age, BMI, fatty liver, and hepatic steatosis grade. A straightforward way to predict fatty liver is to use ultrasonography to determine the size of the liver.

Ultrasound shear wave elastography and liver biopsy to determine liver fibrosis in adult patients.

INTRODUCTION: Liver biopsy is considered as the gold standard for diagnosis of chronic liver disease, yet liver biopsy is an invasive method that may be associated with complications. Therefore, non-invasive methods are needed to diagnose fibrosis. This study was conducted to compare liver stiffness measured by Shear-wave Elastography (SWE) to fibrosis in liver biopsy. METHOD AND MATERIALS: In this prospective study, 176 adult patients with chronic liver disease of different etiologies were included. All patients were evaluated using SWE and a liver biopsy. The diagnostic accuracy of SWE was evaluated using receiver operating characteristics (ROC) plots based on the degree of fibrosis (METAVIR score). SPSS software version 19 was used for statistical analysis and P < 0.05 considered significant. RESULTS: There was a significant correlation between liver stiffness and fibrosis stage (ρ=0.939; P < 0.0001). The ROC curve AUC were 0.871, 0.895 and 0.937 for fibrosis stages F2, F3 and F4 respectively. The cutoff values were 8.6 kPa for F2, 10.7 kPa for F3, and 13.8 kPa for F4, with sensitivity and specificity of 81.76% and 77.01%, 90.20% and 78.40%, 89.53% and 94.38% respectively. CONCLUSION: The results of this study showed that liver SWE is an effective non-invasive method for assessing liver fibrosis in patients with chronic liver disease of different etiologies.

The diagnostic precision of apparent diffusion coefficient (ADC) in grading of malignant endometrial lesions compared with histopathological findings.

OBJECTIVE: The present study aimed to extract apparent diffusion coefficient (ADC) values from the diffusion-weighted imaging (DWI) sequence of endometrial lesions and compare them with tissue specimen results in order to determine the precision of ADC values in grading of malignant endometrial lesions. METHODS: The present prospective study was conducted on 22 patients complaining of abnormal vaginal bleeding or evidence for endometrial thickening or masses detected using the ultrasound. Sampling was performed for pathological examination. MRI T2W+DWI+T1W+Post Contrast T1W were performed for patients. The statistical analysis was performed in SPSS 20 and MedCalc. RESULTS: In this study, although the mean ADC value was lower in patients with endometrial cancer than those with benign endometrial lesions, the difference was not significant (0.86 ± 0.2 mm2/sec versus 1.33 ± 0.53 mm2/sec; P = 0.13). Using the cutoff point of 0.53, the sensitivity and specificity of ADC value for differentiating benign and malignant lesions, respectively, equaled 90.91 and 9.09, with an equal positive and negative predictive value of 50%. In patients with endometrioid adenocarcinoma, mean ADC value was 0.93 ± 0.15 in FIGO Grade I, and 0.76 ± 0.165 in FIGO Grade II. Based on the statistical test, no significant difference existed between the two groups in terms of ADC values. CONCLUSION: Results indicate that the use of a DWI sequence (ADC values) can prevent invasive measures in the diagnosis of benign endometrial lesions and the identification of malignant lesions with a high precision in many patients having accompanying diseases or other cases for which invasive measures cannot be used. Also, there is no significant difference in the mean ADC values between G1 and G2 of endometrioid carcinoma.

Comparison of central venous catheter in brachiocephalic vein and internal jugular vein for the incidence of complications in patients undergoing radiology.

INTRODUCTION: Central venous catheter (CVC) is an essential part of modern medical care that delivers the drugs, intravenous fluids, and intravenous feeding to the vein. So far, limited studies have been carried out on the brachiocephalic vein (BCV) in adults. This study aimed to compare the CVC in the internal jugular vein (IJV) and BCV in order to ease of access and incidence of complication such as infectious and mechanical complications. MATERIALS AND METHODS: This clinical trial was performed on 52 patients who underwent BCV and the IJV catheterization. The patients were compared in two groups of IJV and BCV in order to facilitate catheterization and measure the success rate and catheterization-induced complications. The difference between the two groups was analyzed by Independent t-test and Chi-square tests. RESULTS: Overall, 52 patients underwent intravenous catheterization. The success rate of catheterization in the first attempt was 100%. The problems of catheterization procedure in the IJV group (11.5%) were greater than the BCV group (6.6%). There was no significant difference between the two groups regarding the duration of catheterization, pneumothorax, emphysema, hematoma, arterial puncture, infection, and complete thrombosis, whereas the partial thrombosis in the IJV group (30.76%) was significantly (P < 0.05) greater than the BCV group (23.07%). CONCLUSION: Catheterization in both brachiocephalic and the IJV is an appropriate, highly efficient, stable, and safe procedure and ultrasound-guided catheterization is very reliable and safe method.

Computed tomography-based age estimation of illiac crests calcification in 10-29 year-old individuals.

INTRODUCTION: Estimating the age of the ossification of the iliac crest may help determine the legal age. For this purpose, both anthropological and radiological methods (conventional radiography, ultrasound, Tomography, and MRI) have been used to study different systems. OBJECTIVES: The present study aimed to to evaluate the iliac crest apophysis for age estimation through multidetector computed tomography (MDCT) in 10- to 29-year-old individuals. MATERIALS AND METHODS: This retrospective study was carried out on 10- to 29-year-old individuals who underwent pelvic CT examinations for different reasons in Imam Khomeini and Golestan hospitals of Ahwaz during 2016-2018. The CT examinations of the iliac crest apophysis of 531 patients (267 females and 264 males) were evaluated based on the Kreitner's four-stage system. RESULTS: According to the Kreitner's four-stage system, the minimum age for both sides of the pelvis at stage 2 for girls and boys was 12 years and 13 years, respectively. However, at stage 3, the minimum age for girls and boys was 15 and 17 years, respectively. Accordingly, stage 4 was first observed in boys at age 17 on both sides of the pelvis. In contrast, it appeared in girls at the age of 20 on the right side. CONCLUSION: Along with the findings of other studies, the results showed that multidetector computed tomography (MDCT) is recommended for iliac crest in retrospective cases (where pelvic CT scans already exist), and it may be considered as a supportive method for age-estimation purposes. Moreover, when CT images are used along with other age estimation methods, they provide physicians with valuable supplementary information.