Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography

Abstract

Objectives: This study aimed to estimate the prevalence of liver fibrosis and assess the risk factors for developing significant liver fibrosis in patients with Thalassemia Major (TM). Methods: All patients with TM over the age of 10 years were included in the study. Results: A total of 94 eligible patients underwent 2-D SWE. The median age was 26.7 years. The median of the average 5-year serum ferritin (5yrSF) and liver iron concentration (LIC) assessed by MRI T2* were 1326 µg/L and 6.7 mg/g dw, respectively. Hepatitis C and hepatitis B core antibodies were positive in 38% and 1% of the patients respectively. The proportion of patients with significant fibrosis was 60%. Male gender increased the risk of significant fibrosis (Odds ratio of 0.4; p = .0373). Additionally, the 5yrSF (p = .00661), the LIC (p = .0225) and the lowest LIC of the previous 5 years (p = .0211) were significant. In the multivariable logistic regression model, only 5yrSF (p = .0035) and gender (p = .00984) remained significant. Conclusions: The risk of liver fibrosis is associated with iron overload and gender in patients with TM.

Shear‐wave sonoelastographic assessment of cervix in pregnancy

“…SWS overcomes the limitations of strain elastography by automatically generating an acoustic force that creates a mechanical impulse, leading to tissue displacement in the form of shear‐waves. This technology has been widely used in the assessment of breast or prostate mass and liver cirrhosis 17‐19 . The advantage of SWS is that the generation of the mechanical impulse is operator‐independent 20 …”

“…This technology has been widely used in the assessment of breast or prostate mass and liver cirrhosis. [17][18][19] The advantage of SWS is that the generation of the mechanical impulse is operator-independent. 20 The cervical canal is surrounded by a layer of longitudinal smooth muscle fibers that are wrapped circumferentially by a layer of smooth muscle and collagenous cells, which may act as a "sphincter" to maintain the pregnancy.…”

Interrelationship between liver T2*‐weighted magnetic resonance imaging and acoustic radiation force impulse elastography measurement results and plasma ferritin levels in children with β‐thalassemia major

“…Previous studies have shown that ARFI-e is a reliable method in addition to the T-e in the evaluation of liver fibrosis and cirrhosis. 26 Al-Khabori et al 27 suggested that male sex as an independent factor increases the risk of liver fibrosis in patients with β-TM. In the present study, it was found that the liver ARFI-e measurements of boys were significantly higher than those of girls (p = .023), and this result supports their suggestion.…”

Guest Editor: Raffaella Origa THYROID DISORDERS IN HOMOZYGOUS β-THALASSEMIA: CURRENT KNOWLEDGE, EMERGING ISSUES AND OPEN PROBLEMS

“…57 Liver disease is also associated with an increase in inflammatory cytokines, which negatively affect the hypothalamus pituitary-thyroid axis, leading to suppressed TSH levels in some patients. 58 In the light of eradication of HCV in the thalassemia population with direct-acting antiviral drugs, the prevalence of thyroid dysfunctions could be ameliorated. However long-term studies are needed to confirm this assumption.…”