Transit-time studies with Levovist in patients with and without hepatic cirrhosis: A promising new diagnostic tool

Albrecht, Thomas; Mj, Blomley; Do, Cosgrove; Taylor-Robinson, S.D.; Jayaram,; Eckersley, R; Urbank, A.; Butler-Barnes, Jenny; Patel, Nayna

doi:10.1007/pl00014078

Cited by 23 publications

(12 citation statements)

References 22 publications

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“…Contrary to the indirect signs of fibrosis, such as morphological signs, biological or hemodynamic data [2,46], SPIO-enhanced MR imaging might allow analysis of the distribution of the fibrotic process in liver parenchyma and might be able to better depict its progression on successive examinations. Further studies, including more F2 and F3 patients, are necessary to determine whether this technique, in association with biological tests predicting fibrosis, could limit the use of percutaneous biopsies for the follow-up of chronic liver diseases.…”

Section: Resultsmentioning

confidence: 97%

Non-invasive detection of liver fibrosis: Is superparamagnetic iron oxide particle-enhanced MR imaging a contributive technique?

et al. 2003

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The purpose of our study was to evaluate the ability of superparamagnetic iron oxide (SPIO)-enhanced MR imaging to detect liver fibrosis in patients with chronic liver disease and to compare the findings with histopathological data. Sixty-seven patients with chronic hepatitis ( n=58) or focal nodular hyperplasia (FNH; n=9) were studied using a 1.5-T MR system. The protocol included proton density-weighted, T2-weighted spin-echo (SE) and fast SE (FSE) sequences before and after SPIO administration and T2*-weighted gradient-recalled-echo (GRE) sequences after SPIO. Pre- and post-contrast T2-weighted and T2*-weighted sequences were retrospectively evaluated by three independent observers for evidence of non-tumor hypersignal intensities. Three liver patterns were considered: thick reticulations; thin reticulations; and/or multiple areas of hypersignal intensities. Unenhanced or enhanced patterns were compared with histopathological specimens, which had been obtained by percutaneous biopsy of the right lobe within a maximum of 12 months of MR examination. Liver fibrosis was histologically graded using a five-level scale (F0-F4), according to the METAVIR classification. Histopathology demonstrated significant fibrosis (F2-F4) in 57 patients, non-significant fibrosis in 1 patient (F1), and normal liver surrounding FNH in 9 patients (F0). After SPIO administration, at least one pattern of non-tumor hypersignal intensities was seen in 43 (76%) of the 57 patients with F>/=2 with good agreement (kappa=0.68) compared with 2 (20%) of the 10 F0/1 patients ( p<0.01). Attenuated non-homogeneous liver-signal intensities with persistent thick reticulations, thin reticulations, or multiple areas of hypersignals were observed in, respectively, 30, 52, and 56% of patients with F>/=2 with moderate agreement (kappa=0.51). Before SPIO, MR images were positive in 21 of 57 (37%) F>/=2 and zero F0/1 patients. Post-contrast proton-density-weighted and T2*-weighted GRE were the most sensitive sequences for detecting non-tumor hypersignal intensities. In patients with chronic liver diseases, SPIO-enhanced MR imaging exhibits non-tumor hypersignal intensities indicative of liver fibrosis by decreasing the signal from the non-fibrotic areas where Kupffer cells are present.

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Section: Resultsmentioning

confidence: 97%

Non-invasive detection of liver fibrosis: Is superparamagnetic iron oxide particle-enhanced MR imaging a contributive technique?

et al. 2003

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“…The diagnosis of diffuse parenchymal liver disease may be difficult using ultrasound, and biopsies may be warranted. In a paper by Albrecht and colleagues, a significantly faster transit time was found in patients with cirrhosis as compared with normal and non-cirrhotic patients [30]. This may also prove useful in various problems in liver-transplanted patients.…”

Section: Liver Parenchymamentioning

confidence: 92%

Ultrasound contrast agents: clinical applications

Jakobsen

2001

Eur Radiol

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Ultrasound contrast agents (USCA) for intravenous injections are usually gas-filled microbubbles with a mean diameter less than that of a red blood corpuscle. There are only a few products on the market at the time of this writing, but several companies have various agents under development. This paper covers both established USCA on the market, and some new agents under clinical evaluation. The potential of improving ultrasound imaging using USCA depends on several factors. These factors include the pharmacokinetic and pharmacodynamic properties of the products, which determine the effects they have on various ultrasound imaging techniques. Furthermore, the proper clinical application of the agents requires a combination of technical and medical knowledge by the examiner, dedicated equipment, a disease that can be diagnosed or characterised by ultrasound and USCA, and a cooperative patient. Taking into account these factors, USCA can be used for improving the detection, characterisation and follow-up of diseases of several vascular beds and parenchymal organs from head to foot.

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“…Mathematical analysis of these time–intensity curves yields quantitative hemodynamic indices relating to blood flow in either tissue volumes or within individual vessels [15]. Perfusion parameters are of interest since changes in vascularity and blood flow secondary to pathology generate alterations in the time–intensity curve [16]. Furthermore, contrast-enhanced ultrasound allows a more complete characterization of focal lesions [17].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia

Nardini¹,

Girolamo²,

Leopardi³

et al. 2014

BMC Vet Res

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BackgroundContrast-enhanced diagnostic imaging techniques are considered useful in veterinary and human medicine to evaluate liver perfusion and focal hepatic lesions. Although hepatic diseases are a common occurrence in reptile medicine, there is no reference to the use of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) to evaluate the liver in lizards. Therefore, the aim of this study was to evaluate the pattern of change in echogenicity and attenuation of the liver in green iguanas (Iguana iguana) after administration of specific contrast media.ResultsAn increase in liver echogenicity and density was evident during CEUS and CECT, respectively. In CEUS, the mean ± SD (median; range) peak enhancement was 19.9% ± 7.5 (18.3; 11.7-34.6). Time to peak enhancement was 134.0 ± 125.1 (68.4; 59.6-364.5) seconds. During CECT, first visualization of the contrast medium was at 3.6 ± 0.5 (4; 3-4) seconds in the aorta, 10.7 ± 2.2 (10.5; 7-14) seconds in the hepatic arteries, and 15 ± 4.5 (14.5; 10-24) seconds in the liver parenchyma. Time to peak was 14.1 ± 3.4 (13; 11-21) and 31 ± 9.6 (29; 23-45) seconds in the aorta and the liver parenchyma, respectively.ConclusionCEUS and dynamic CECT are practical means to determine liver hemodynamics in green iguanas. Distribution of contrast medium in iguana differed from mammals. Specific reference ranges of hepatic perfusion for diagnostic evaluation of the liver in iguanas are necessary since the use of mammalian references may lead the clinician to formulate incorrect diagnostic suspicions.

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Transit-time studies with Levovist in patients with and without hepatic cirrhosis: A promising new diagnostic tool

Cited by 23 publications

References 22 publications

Non-invasive detection of liver fibrosis: Is superparamagnetic iron oxide particle-enhanced MR imaging a contributive technique?

Non-invasive detection of liver fibrosis: Is superparamagnetic iron oxide particle-enhanced MR imaging a contributive technique?

Ultrasound contrast agents: clinical applications

Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia

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