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Artificial intelligence in liver ultrasound

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World Journal of Gastroenterology 2022年第27期28卷 3398-3409页

作者： Liu-Liu Cao Mei Peng Xiang Xie Gong-Quan Chen Shu-Yan Huang Jia-Yu Wang fan Jiang Xin-Wu Cui christoph f dietrich Department of Medical Ultrasound The Second Hospital of Anhui Medical UniversityHefei 230601Anhui ProvinceChina Department of Medical Ultrasound Minda Hospital of Hubei Minzu UniversityEnshi 445000Hubei ProvinceChina Department of Medical Ultrasound The First People's Hospital of HuaihuaHuaihua 418000Hunan ProvinceChina Department of Medical Ultrasound Tongji Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department Allgemeine Innere Medizin Kliniken Hirslanden Beau SiteSalem und PermanenceBern 3626Switzerland

Artificial intelligence(AI)is playing an increasingly important role in medicine,especially in the field of medical imaging.It can be used to diagnose diseases and predict certain statuses and possible events that may happen.Recently,more and more studies have confirmed the value of AI based on ultrasound in the evaluation of diffuse liver diseases and focal liver lesions.It can assess the severity of liver fibrosis and nonalcoholic fatty liver,differentially diagnose benign and malignant liver lesions,distinguish primary from secondary liver cancers,predict the curative effect of liver cancer treatment and recurrence after treatment,and predict microvascular invasion in hepatocellular carcinoma.The findings from these studies have great clinical application potential in the near future.The purpose of this review is to comprehensively introduce the current status and future perspectives of AI in liver ultrasound.

关键词： Machine learning Deep learning Radiomics Diffuse liver diseases focal liver diseases Ultrasound

Ultrasound findings in autoimmune hepatitis

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World Journal of Gastroenterology 2018年第15期24卷 1583-1590页

作者： Yi Dong Andrej Potthoff christoph Klinger Ana Paula Barreiros Dariusz Pietrawski christoph f dietrich Department of Ultrasound Zhongshan Hospital Fudan University Department of Gastroenterology Hepatology and Endocrinology Medizinische Hochschule Hannover Department of Internal Medicine 1 Klinikum Ludwigsburg German Organ Transplantation foundation Region Mitte Department of Internal Medicine 2 Caritas-Krankenhaus Bad Mergentheim

Ultrasound findings in autoimmune hepatitis(AIH) have not been reported systematically so far. The use of reliable and accurate noninvasive methods for determining fibrosis stage is important in evaluation of treatment efficacy and fibrosis regression in AIH. Imaging plays an important role in detection of complications and ruling out other possible causes of chronic liver diseases. Ultrasound elastography cutoff values in AIH patients are not the same as those in patients with chronic viral hepatitis or non-alcoholic fatty liver disease. AIH is characterized by wide fluctuations in inflammatory activity. Here we report on current knowledge of ultrasound findings in AIH.

关键词： Autoimmune hepatitis fibrosis stage Ultrasound Elastography Chronic liver diseases

Endoscopic ultrasonography-guided endoscopic treatment of pancreatic pseudocysts and walled-off necrosis:New technical developments

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World Journal of Gastroenterology 2014年第43期20卷 16191-16196页

作者： Barbara Braden christoph f dietrich Translational Gastroenterology Unit Oxford University Hospitals NHS TrustOxford OX3 9DUUnited Kingdom Med.Klinik 2 Caritas HospitalUhlandstr.797980 Bad MergentheimGermany

In the last decades,the treatment of pancreatic pseudocysts and necrosis occurring in the clinical context of acute and chronic pancreatitis has shifted towards minimally invasive endoscopic interventions.Surgical procedures can be avoided in many cases by using endoscopically placed,Endoscopic ultrasonography-guided techniques and drainages.Endoscopic ultrasound enables the placement of transmural plastic and metal stents or nasocystic tubes for the drainage of peripancreatic fluid collections.The development of selfexpanding metal stents and exchange free delivering systems have simplified the drainage of pancreatic fluid collections.This review will discuss available therapeutic techniques and new developments.

关键词： Pancreatic pseudocyst Walled-off necrosis Endoscop

Ultrasound imaging of abdominal sarcoidosis: State of the art

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World Journal of Clinical Cases 2019年第7期7卷 809-818页

作者： Claudio Tana Cosima Schiavone Andrea Ticinesi fabrizio Ricci Maria Adele Giamberardino francesco Cipollone Mauro Silingardi Tiziana Meschi christoph f dietrich Internal Medicine and Critical Subacute Care Unit Medicine Geriatric-Rehabilitation Department and Department of Medicine and Surgery University-Hospital of Parma Department of Internistic Ultrasound "G. D’Annunzio" University of Chieti Department of Imaging and Clinical Sciences Institute for Advanced Biomedical Technologies "G. D’Annunzio" University of Chieti Geriatrics Clinic Department of Medicine and Science of Aging"G. D’Annunzio" University of Chieti Medical Clinic Department of Medicine and Science of Aging "G.D’Annunzio" University of Chieti Internal Medicine Unit Maggiore Hospital of Bologna Caritas-Krankenhaus Bad Mergentheim Academic Teaching Hospital of the University of Würzburg

Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.

关键词： Sarcoidosis Sarcoid lesions Granulomatous disorders Liver Spleen Rare diseases Ultrasound Contrast-enhanced ultrasound

Artificial intelligence for hepatitis evaluation

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World Journal of Gastroenterology 2021年第34期27卷 5715-5726页

作者： Wei Liu Xue Liu Mei Peng Gong-Quan Chen Peng-Hua Liu Xin-Wu Cui fan Jiang christoph f dietrich Department of Medical Ultrasound The Second Hospital of Anhui Medical UniversityHefei 230601Anhui ProvinceChina Department of Medical Ultrasound Minda Hospital of Hubei Minzu UniversityEnshi 445000Hubei ProvinceChina Department of Medical Ultrasound The First Affiliated Hospital of Shaoyang UniversityShaoyang 422000Hunan ProvinceChina Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine Department of Medical UltrasoundTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department Allgemeine Innere Medizin Kliniken Hirslanden Beau SiteSalem und PermanenceBern 3626Switzerland

Recently,increasing attention has been paid to the application of artificial intelligence(AI)to the diagnosis of diverse hepatic diseases,which comprises traditional machine learning and deep learning.Recent studies have shown the possible value of AI based data mining in predicting the incidence of hepatitis,classifying the different stages of hepatitis,diagnosing or screening for hepatitis,forecasting the progression of hepatitis,and predicting response to antiviral drugs in chronic hepatitis C patients.More importantly,AI based on radiology has been proven to be useful in predicting hepatitis and liver fibrosis as well as grading hepatocellular carcinoma(HCC)and differentiating it from benign liver tumors.It can predict the risk of vascular invasion of HCC,the risk of hepatic encephalopathy secondary to hepatitis B related cirrhosis,and the risk of liver failure after hepatectomy in HCC patients.In this review,we summarize the application of AI in hepatitis,and identify the challenges and future perspectives.

关键词： Machine learning Deep learning Radiomics Hepatitis fibrosis Hepatocellular carcinoma

Nomogram for predicting transmural bowel infarction in patients with acute superior mesenteric venous thrombosis

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World Journal of Gastroenterology 2020年第26期26卷 3800-3813页

作者： Meng Jiang Chang-Li Li Chun-Qiu Pan Wen-Zhi Lv Yu-fei Ren Xin-Wu Cui christoph f dietrich Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine Department of Medical UltrasoundTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department of Geratology Hubei Provincial Hospital of Integrated Chinese and Western MedicineWuhan 430015Hubei ProvinceChina Department of Emergency Medicine Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Artificial Intelligence Julei Technology CompanyWuhan 430030Hubei ProvinceChina Department of Computer Center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department of Internal Medicine Hirslanden ClinicBerne 27804Switzerland

BACKGROUND The prognosis of acute mesenteric ischemia(AMI)caused by superior mesenteric venous thrombosis(SMVT)remains undetermined and early detection of transmural bowel infarction(TBI)is crucial.The predisposition to develop TBI is of clinical concern,which can lead to fatal sepsis with hemodynamic instability and multi-organ failure.Early resection of necrotic bowel could improve the prognosis of AMI,however,accurate prediction of TBI remains a challenge for clinicians.When determining the eligibility for explorative laparotomy,the underlying risk factors for bowel infarction should be fully evaluated.AIM To develop and externally validate a nomogram for prediction of TBI in patients with acute SMVT.METHODS Consecutive data from 207 acute SMVT patients at the Wuhan Tongji Hospital and 89 patients at the Guangzhou Nanfang Hospital between July 2005 and December 2018 were included in this study.They were grouped as training and external validation cohort.The 207 cases(training cohort)from Tongji Hospital were divided into TBI and reversible intestinal ischemia groups based on the final therapeutic outcomes.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for TBI using the training data,and a nomogram was subsequently developed.The performance of the nomogram was evaluated with respect to discrimination,calibration,and clinical usefulness in the training and external validation cohort.RESULTS Univariate and multivariate logistic regression analyses identified the following independent prognostic factors associated with TBI in the training cohort:The decreased bowel wall enhancement(OR=6.37,P2 mmol/L(OR=3.14,P=0.009)and previous history of deep venous thrombosis(OR=6.37,Pfour factors,the nomogram achieved good calibration in the training set[area under the receiver operator characteristic curve(AUC)0.860;95%CI:0.771-0.925]and the external validation set(AUC 0.851

关键词： Superior mesenteric venous thrombosis Acute mesenteric ischemia Transmural bowel infarction Reversible intestinal ischemia Predictors Nomogram

How to perform gastrointestinal ultrasound: anatomy and normal findings

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World Journal of Gastroenterology 2017年第38期23卷 6931-6941页

作者： Nathan S S Atkinson Robert V Bryant Yi Dong Christian Maaser Torsten Kucharzik Giovanni Maconi Anil K Asthana Michael Blaivas Adrian Goudie Odd Helge Gilja Dieter Nuernberg Dagmar Schreiber-dietrich christoph f dietrich Translational Gastroenterology Unit Oxford University Hospitals NHS Foundation Trust School of Medicine University of Adelaide Department of Gastroenterology and Hepatology Royal Adelaide Hospital Department of Ultrasound Zhongshan Hospital Fudan University Ambulanzzentrum Gastroenterologie Klinikum Lüneburg Department of Gastroenterology Stadtisches Klinikum Luneburg gGmbH Gastrointestinal Unit Department of Biomedical and Clinical Sciences 'L.Sacco' University Hospital Department of Gastroenterology and Hepato-logy The Alfred Hospital Monash University Piedmont Hospital Department of Emergency Medicine fremantle Hospital and Health Service Emergency Department National Centre for Ultrasound in Gastro- enterology Haukeland University Hospital Department of Clinical Medicine University of Bergen Department of Gastroenterology Brandenburg Medical School Med. Klinik 2 Caritas-Krankenhaus Bad Mergentheim

Gastrointestinal ultrasound is a practical, safe, cheap and reproducible diagnostic tool in inflammatorybowel disease gaining global prominence amongst clinicians. Understanding the embryological processes of the intestinal tract assists in the interpretation of abnormal sonographic findings. In general terms, the examination principally comprises interrogation of the colon, mesentery and small intestine using both lowfrequency and high-frequency probes. Interpretation of findings on GIUS includes assessment of bowel wall thickness, symmetry of this thickness, evidence of transmural changes, assessment of vascularity using Doppler imaging and assessment of other specific features including lymph nodes, mesentery and luminal motility. In addition to B-mode imaging, transperineal ultrasonography, elastography and contrast-enhanced ultrasonography are useful adjuncts. This supplement expands upon these features in more depth.

关键词： Ultrasound Intestinal Inflammatory bowel disease Guidelines Teaching

Sonographic signs of neutropenic enterocolitis

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World Journal of Gastroenterology 2006年第9期12卷 1397-1402页

作者： christoph f dietrich Stella Hermann Stefan Klein Barbara Braden Department of Internal Medicine Cari-tas Hospital Bad Mergentheim Bad MergentheimGermany Medical Department University Hospital Frankfurt/MainGermany

瞄准：与 neutropenic 小肠结肠炎在病人在诊断和后续的时间调查 sonographic 特征。方法：在有 neutropenic 小肠结肠炎的 14 个病人的 sonographic 调查结果被描述并且评估了考虑症状和临床的结果。结果：在有 neutropenic 小肠结肠... 详细信息

瞄准：与 neutropenic 小肠结肠炎在病人在诊断和后续的时间调查 sonographic 特征。方法：在有 neutropenic 小肠结肠炎的 14 个病人的 sonographic 调查结果被描述并且评估了考虑症状和临床的结果。结果：在有 neutropenic 小肠结肠炎的所有病人， ileocoecal 区域涉及墙变厚 >10 公里。一个透壁的煽动性的模式，变厚的肠墙的亢奋的由脉管形成和免费腹的液体是普通调查结果。肠墙的 sonographically 揭示的厚度与致命的结果(P<0.03 ) 被联系。在 11 个幸存病人，临床的症状的改进被肠的墙厚度的进步减小伴随。结论：肠的高端 sonography 是为诊断的一个有用工具，对预后的评价和有 neutropenic 小肠结肠炎的病人的后续。ultrasonographically 揭示的肠厚度反映严厉和疾病的功课，并且似乎为临床的结果预兆。

关键词：小肠炎症中性白细胞增多症超声波检查内皮细胞

Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using self-expanding metal stents without fluoroscopy

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World Journal of Gastrointestinal Endoscopy 2018年第5期10卷 93-98页

作者： Barbara Braden Andreas Koutsoumpas Michael A Silva Zahir Soonawalla christoph f dietrich Translational Gastroenterology Unit Oxford University Hospitals Hepatobiliary Surgery Oxford University Hospitals Caritas Krankenhaus Bad Mergentheim

AIM To investigate whether endoscopic ultrasound(EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis(WOPN) is feasible without fluoroscopy.METHODS Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents(fCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by theoperators as "visible" or "not visible":(1) Access to the cyst by needle or cystotome;(2) insertion of a guide wire;(3) introducing of the diathermy and delivery system;(4) opening of the distal flange; and(5) slow withdrawal of the delivery system until contact of distal flange to cavity wall. Technical success was defined as correct positioning of the fCSEMS without the need of fluoroscopy.RESULTS In total, 27 consecutive patients with symptomatic WOPN referred for EUS-guided drainage were included. In 2 patients large traversing arteries within the cavity were detected by color Doppler, therefore the insertion of fCSEMS was not attempted. In all other patients(92.6%) EUS-guided transgastric stent insertion was technically successful without fluoroscopy. All steps of the procedure could be clearly visualized by EUS. Nine patients required endoscopic necrosectomy through the fCSEMS. Adverse events were two readmissions with fever and one self-limiting bleeding; there was no procedure-related mortality. CONCLUSION The good endosonographic visibility of the fCSEMS delivery system throughout the procedure allows safe EUS-guided insertion without fluoroscopy making it available as bedside intervention for critically ill patients.

关键词： Necrotizing pancreatitis Peripancreatic fluid collection Therapeutic endoscopic ultrasound Transmural drainage Acute pancreatitis