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Portal vein thrombosis in cirrhosis: Why a well-known complication is still matter of debate

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World Journal of Gastroenterology 2019年第31期25卷 4437-4451页

作者： Mariella Faccia Maria elena Ainora Francesca Romana Ponziani Laura Riccardi Matteo Garcovich Antonio Gasbarrini Maurizio pompili Maria Assunta Zocco Department of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University

Portal vein thrombosis(PVT)represents a well-known complication during the natural course of liver cirrhosis(LC),ranging from asymptomatic cases to lifethreating conditions related to portal hypertension and hepatic *** flow stasis,complex acquired hypercoagulable disorders and exogenous factors leading to endothelial dysfunction have emerged as key factors for PVT ***,PVT occurrence remains unpredictable and many issues regarding its natural history,prognostic significance and treatment are still *** particular although spontaneous resolution or disease stability occur in most cases of PVT,factors predisposing to disease progression or recurrence after spontaneous recanalization are not clarified as ***,PVT impact on LC outcome is still debated,as PVT may represent itself a consequence of liver fibrosis and hepatic dysfunction *** and transjugular intrahepatic portosystemic shunt are considered safe and effective in this setting and are recommended in selected cases,even if the safer therapeutic option and the optimal therapy duration are still ***,their impact on mortality rates should be addressed more *** this review we present the most debated questions regarding PVT,whose answers should come from prospective cohort studies and large sample-size randomized trials.

关键词： Portal vein thrombosis Liver cirrhosis Hypercoagulability Anticoagulation Direct oral anticoagulants

Elastography as a predictor of liver cirrhosis complications after hepatitis C virus eradication in the era of direct-acting antivirals

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World Journal of Hepatology 2021年第11期13卷 1663-1676页

作者： Lucia Cerrito Maria elena Ainora Alberto Nicoletti Matteo Garcovich Laura Riccardi Maurizio pompili Antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario"A.Gemelli"IRCCSCatholic University of Rome(Italy)Rome 00168Italy

Chronic inflammation due to hepatitis C virus(HCV)infection leads to liver fibrosis and rearrangement of liver tissue,which is responsible for the development of portal hypertension(PH)and hepatocellular carcinoma(HCC).The advent of direct-acting antiviral drugs has revolutionized the natural history of HCV infection,providing an overall eradication rate of over 90%.Despite a significant decrease after sustained virological response(SVR),the rate of HCC and liver-related complications is not completely eliminated in patients with advanced liver *** the reasons are still unclear,cirrhosis itself has a residual risk for the development of HCC and other PH-related *** elastography is a recently developed non-invasive technique for the assessment of liver *** the achievement of SVR,liver stiffness(LS)usually decreases,as a consequence of reduced inflammation and,possibly,*** studies emphasized the application of LS assessment in the management of patients with SVR in order to define the risk for developing the complications of chronic liver disease(functional decompensation,gastrointestinal bleeding,HCC)and to optimize long-term prognostic outcomes in clinical practice.

关键词： Direct-acting antiviral agents Liver stiffness Portal hypertension Hepatocellular carcinoma

Usefulness of contrast enhanced ultrasound in monitoring therapeutic response after hepatocellular carcinoma treatment

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World Journal of Hepatology 2015年第14期7卷 1866-1874页

作者： Davide Roccarina Matteo Garcovich Maria elena Ainora Laura Riccardi Maurizio pompili Antonio Gasbarrini Maria Assunta Zocco Department of Internal Medicine Catholic University of Sacred Heart

In the last years, the development in the oncology field has been huge and rapid. In particular, the evaluation of response to anti-tumour treatments has been being object of intense research, producing significant changes. Response assessment after therapy in solid neoplasias has always used radiological imaging techniques, with tumour size reduction representing a presumed therapeutic efficacy. However, with the introduction of anti-angiogenetic drugs the evaluation of tumour size has become unsuitable because some tumours, under treatment, show only tumour perfusion changes rather than lesion shrinkage. Between different imaging techniques with contrast-enhancement, contrastenhanced ultrasound(CEUS) and, in particular, dynamic CEUS have arisen as a promising and non-invasive device for monitoring cancer treatments. Moreover, the introduction of perfusion software has even more refined the technique since it is able to provide quantitative parameters related to blood flow and blood volume that can be associated with tumour response and clinical outcome such as the progression free survival and the overall survival. Here, we give an overview of the current status of CEUS in monitoring hepatocellular carcinoma response to different kind of treatments.

关键词： Dynamic contrast-enhanced ultrasound Hepatocellular carcinoma Ablative treatment Antiangiogeneticdrugs Time-intensitive curve

Early post-operative MRI： correlation with progression-free survival and overall survival time in malignant gliomas

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中国神经肿瘤杂志 2006年第3期4卷 218-218页

作者： Vidiri A Carapella CM Pace A Mirri A Fabis A Carosi M Giannarelli D pompili A Jandolo B Occhipinti E Di Giovanni S Crecco M Department of Diagnostic Imaging Regina Elena Cancer Institute Rome Italy

Forty-seven patients with Glioblastoma (42) and Anaplastic Astrocytoma (5) were studied with MR 24 hrs after surgery。In order to evaluate the role of early MR in defining the extent of surgical resection and its relation with the prognosis of malignant glioma patients, three categories of surgical resection were considered: gross total, sub-total and partial resection。The results were correlated with progression-free survival (PFS) and overall survival (ST)。As demonstrated by early-MR, gross total resection was performed in 17 patients, sub-total and partial resection in 19 and 11 patients, respectively。The PFS was 6 months in gross total resection, 6 and 3 months in sub-total and in partial resection, respectively。The median survival time was 16 months in total resection patients, 13 months and 7 months in sub-total resection and partial resection patients, respectively。

关键词：磁共振成像手术后期间预后肿瘤/外科学肿瘤/诊断人类