No abstract

Objective: To assess the inter-and intra-observer variability of acoustic radiation force impulse (ARFI) quantification in liver segments with influence of age, body mass index (BMI) and liver capsule-to-box (CB) distance. Methods: 10 healthy volunteers were examined twice, by three experienced operators, separated by a 1-week interval. 10 readings were obtained, from segments 3, 5/6 and 7/8. Age, BMI and the CB distance were noted. The Cronbach a statistic for analysis of reliability was performed for the inter-and intra-observer studies. Multivariate linear regression models determined significance of the other parameters. . For both the inter-and intra-observer study, the Cronbach a statistic was $0.7 (reliable) when taken from segments 5/6 and 7/8 but ,0.7 (unreliable) for segment 3. BMI and age showed significant (p,0.0001) but contrasting correlation (segment 5/6: BMI r50.02, age r520.02; segment 7/8: BMI r520.01, age r50.01) with ARFI velocities when analysed for the segments deemed reliable. A weak negative correlation between ARFI velocities and liver CB distance was demonstrated for both assessed segments (segment 5/6, r520.08; segment 7/8, r520.06; p,0.001). Conclusion: With trained operators, ARFI is a reliable and reproducible method of liver stiffness quantification in segments 5/6 and 7/8 but acquisition of measurements from segment 3 should be avoided. Values obtained deeper to the liver capsule allow more reliable liver stiffness quantification.

Complications of vascular access are an important cause of morbidity and mortality in hemodialysis patients. 1 It is widely accepted that an arteriovenous fistula (AVF) is the optimal form of vascular access, with better patency and lower infection rates than arteriovenous grafts and central

Contrast-enhanced ultrasound is a useful adjuvant to color Doppler ultrasound examination of a focal lesion in the testis ipsilateral to epididymitis to improve the characterization of nonvascularized tissue.