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World Journal of Hepatology 2024年第7期16卷 1018-1028页

作者： Jia-Yao Huang Jian-Yun Peng Hai-Yi Long Xian Zhong Yu-Hua Xie Lu Yao Xiao-Yan Xie Man-Xia Lin Department of Medical Ultrasonics The First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina

BACKGROUND liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma(HCC),but a convenient and comprehensive method to assess liver condition is *** stiffness(LS)measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver *** hepatitis B(CHB)is an important risk factor for HCC progression,but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral *** hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver *** To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and *** A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus(HBV)-DNA levels[HBV-DNA≥100.00 IU/mL as Pos group(n=200)andliver *** A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition(Pliver condition indices(P40 U/L),the correlations between LS and liver condition indices were not significant(P>0.05).CONCLUSION LS was significantly correlated with most liver condition indices in patients with CHB and ***,these correlations varied according to differences in HBV-DNA and transaminase concentrations.

关键词： liver function liver stiffness Elastography Chronic hepatitis B Hepatocellular carcinoma

liver stiffness in pregnant women with intrahepatic cholestasis of pregnancy:A case control study

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World Journal of Hepatology 2023年第7期15卷 904-913页

作者： Juliane Nees Franziska J Ammon Johannes Mueller Herbert Fluhr Sebastian Mueller Department of Gynecology and Obstetrics University Hospital HeidelbergHeidelberg 69120Germany Center for Alcohol Research University Hospital HeidelbergHeidelberg 69120Germany Division of Obstetrics Department of Obstetrics and GynecologyMedical University of GrazGraz 8036Austria

BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn *** diagnosis is primarily based on elevated serum levels of bile *** a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within *** To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated *** LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and *** 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control *** laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also *** Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(Plivery in the ICP *** acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and *** multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile *** In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte *** association with conventional laboratory markers,LS provides additional non-invasive informati

关键词： Intrahepatic cholestasis of pregnancy Transient elastography Bile acids liver stiffness High risk pregnancy

Can liver stiffness measurement accurately predict disease progression and clinical outcome in patients with metabolic dysfunction-associated steatotic liver disease and bridging fibrosis or cirrhosis?

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 912-915页

作者： Diederick J.van Doorn Adriaan G.Holleboom R.Bart Takkenberg Joanne Verheij Marten A.Lantinga Department of Gastroenterology and Hepatology Amsterdam UMCUniversity of AmsterdamAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamThe Netherlands Department of Vascular Medicine Internal MedicineAmsterdam UMCUniversity of AmsterdamAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamThe Netherlands Department of Hepatopancreatobiliary Pathology Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

Diederick *** Doorn1,Adriaan ***2,*** Takkenberg1,Joanne Verheij3,Marten ***11Department of Gastroenterology and Hepatology,Amsterdam UMC,University of Amsterdam,Amsterdam Gastroenterology Endocrinology Metabolism,Amsterdam,The Netherlands;2Department of Vascular Medicine,Internal Medicine,Amsterdam UMC,University of Amsterdam,Amsterdam Gastroenterology Endocrinology Metabolism,Amsterdam,The Netherlands;3Department of Hepatopanc Metabolic dysfunction-associated steatotic liver disease(MASLD)-until recently termed non-alcoholic fatty liver disease(NAFLD)-is a rising cause of chronic liver disease with an estimated global prevalence of 30%(1).

关键词： Cirrhosis liver stiffness steatotic liver disease

Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

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World Journal of Clinical Cases 2022年第17期10卷 5566-5576页

作者： Anya Mezina Arunkumar Krishnan Tinsay A Woreta Kevin B Rubenstein Eric Watson Po-Hung Chen Carla Rodriguez-Watson Department of Medicine Johns Hopkins School of MedicineBaltimoreMD 21287United States Division of Gastroenterology and Hepatology Johns Hopkins School of MedicineBaltimoreMD 21231United States Mid-Atlantic Permanente Research Institute Kaiser Permanente Mid-Atlantic StatesRockville 20852United States Department of Health Policy and Management Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMD 21287United States Innovation in Medical Evidence Development and Surveillance(IMEDS)Program Reagan-Udall Foundation for the FDAWashington20036United States

BACKGROUND liver fibrosis is a common pathway of liver injury and is a feature of most chronic liver *** progression varies markedly in patients with hepatitis C virus(HCV).liver stiffness has been recommended as a parameter of fibrosis progression/regression in patients with *** To investigate changes in liver stiffness measured by transient elastography(TE)in a large,racially diverse cohort of United States patients with chronic hepatitis C(CHC).METHODS We evaluated the differences in liver stiffness between patients treated with direct-acting antiviral(DAA)therapy and untreated *** had≥2 TE measurements and no prior DAA *** used linear regression to measure the change in liver stiffness between first and last TE in response to treatment,controlling for age,sex,race,diabetes,smoking status,human immunodeficiency virus status,baseline alanine aminotransferase,and baseline liver *** regression models analyzed the change in liver stiffness as measured by kPa,stratified by cirrhosis *** Of 813 patients,419(52%)initiated DAA *** liver stiffness was 12 kPa in 127(16%).Median time between first and last TE was 11.7 and 12.7 mo among treated and untreated patients,*** was no significant change in liver stiffness observed over time in either the group initiating DAA treatment(0.016 kPa/month;CI:-0.051,0.084)or in the untreated group(0.001 kPa/mo;CI:-0.090,0.092),controlling for covariates.A higher baseline kPa score was independently associated with decreased liver *** DAA treatment was not associated with a differential change in liver stiffness over time in patients with CHC compared to untreated patients.

关键词： Chronic hepatitis C liver stiffness Cirrhosis Transient elastography Direct-acting antiviral therapy

liver stiffness reversibly increases during pregnancy and independently predicts preeclampsia

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World Journal of Gastroenterology 2018年第38期24卷 4393-4402页

作者： Franziska J Ammon Anna Kohlhaas Omar Elshaarawy Johannes Mueller Thomas Bruckner Christof Sohn Gabriele Fluhr Herbert Fluhr Sebastian Mueller Department of Obstetrics and Gynecology University of Heidelberg Department of Medicine and Center for Alcohol Research Liver Disease and NutritionSalem Medical CenterUniversity of Heidelberg Institute of Medical Biometry und Informatics University of Heidelberg

AIM To study liver stiffness(LS) during pregnancy and its association with complications during *** In this observational, diagnostic study, 537 pregnant women were prospectively enrolled at the Department of Obstetrics and Gynecology, University hospital Heidelberg and Salem Medical Center. LS was measured using the Fibroscan device(Echosens, Paris) in all women and in 41 cases 24 h after delivery. Clinical and morphological data were recorded and abdominal ultrasound and standard laboratory tests were performed. No complications were observed in 475 women(controls) while preeclampsia and intrahepatic cholestasis of pregnancy(ICP) developed in 22 and 40 women, *** In controls, LS increased significantly from initially 4.5 ± 1.2 kPa in the second trimester to 6.0 ± 2.3 kPa(P livery from 7.2 ± 3.3 kPa down to 4.9 ± 2.2 kPa(P < 0.001).CONCLUSION During pregnancy, LS significantly and reversibly increases in the final trimester of pregnant women without complications. In women with preeclampsia, LS is significantly elevated and an independent noninvasive predictor.

关键词： Pregnancy Transient elastography liver stiffness Pregnancy complications Hemolysis,elevated liver enzymes and low platelets syndrome Intrahepatic cholestasis of pregnancy Preeclampsia

Multiparametric ultrasound as a new concept of assessment of liver tissue damage

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World Journal of Gastroenterology 2024年第12期30卷 1663-1669页

作者： Angela Peltec Ioan Sporea Department of Internal Medicine Discipline of GastroenterologyState University of Medicine and Pharmacy"Nicolae Testemitanu"Chishinev 2019Moldova Department of Gastroenterology and Hepatology "Victor Babes"University of Medicine and PharmacyTimisoara 300736Romania

liver disease accounts for approximately 2 million deaths per year *** chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the *** changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue *** methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in *** US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic *** elastography can assess liver stiffness,serving as a surrogate marker for liver *** is important to note that interpreting these values should not rely solely on a histological ***-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver *** evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness *** measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild *** controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly ***-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of *** parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US *** US(MPUS)of the liver introduces a new concept for complete noninvasive *** encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,

关键词： Multiparametric ultrasound Ultrasound-based elastography liver stiffness Noninvasive diagnostic test for chronic liver disease liver steatosis assessment Portal hypertension evaluation

Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 20-24页

作者： Stefania Gioia Adriano De Santis Giulia d’Amati Silvia Nardelli Alessandra Spagnoli Arianna Di Rocco Lorenzo Ridola Oliviero Riggio Department of Translational and Precision Medicine Sapienza University of RomeRomeItaly Department of Radiological Oncologicaland Pathological SciencesSapienza University of RomeRomeItaly Department of Public Health and Infectious Diseases Sapienza University of RomeRomeItaly

Background:Porto-sinusoidal vascular disease(PSVD)and portal vein thrombosis(PVT)are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal *** PVT may be a consequence of PSVD,in PVT patients at presentation,a pre-existing PSVD should be *** these patients the identification of an underlying PSVD would have relevant implication regarding follow-up and therapeutic management,but it could be *** this setting ultrasonography may be valuable in differential *** aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and“pure”PVT and then to suspect PVT secondary to a pre-existing ***:Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse(ARFI).Results:ARFI was higher and superior mesenteric vein(SMV)diameter was wider in PSVD patients than in PVT ***,a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT(the area under the curve=0.780;95%confidence interval:0.690-0.869).Conclusions:A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.

关键词： Non-cirrhotic portal hypertension Porto-sinusoidal vascular disease Chronic portal vein thrombosis liver stiffness Portal hypertension Acoustic radiation force impulse

Predicting liver function after hemihepatectomy in patients with hepatocellular carcinoma using different modalities

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World Journal of Clinical Oncology 2024年第6期15卷 783-785页

作者： Erfan Taherifard Anwaar Saeed Department of Medicine University of Pittsburgh Medical CenterPittsburghPA 15232United States UPMC Hillman Cancer Center University of Pittsburgh Medical CenterPittsburghPA 15232United States

In response to *** et al's study on prognostic factors for post-hemihep-atectomy outcomes in hepatocellular carcinoma(HCC)patients,this critical review identifies methodological limitations and proposes enhancements for future *** the study identifies liver stiffness measure and standard residual liver volume as potential predictors,concerns regarding small sample size,reliance on biochemical markers for safety assessment,and inadequate ad-justment for confounding variables are *** for rigorous methodology,including robust statistical analysis,consideration of confounding factors,and selection of outcome measures with clinical components,are proposed to strengthen prognostic ***,validation of novel evaluation models is crucial for enhancing clinical applicability and advancing understanding of postoperative outcomes in patients with HCC undergoing hem-ihepatectomy.

关键词： Hepatocellular carcinoma liver cirrhosis Hepatectomy liver failure Standard residual liver volume liver stiffness

ACE Score Identifies HBeAg-negative Inactive Carriers at a Single-point Evaluation,Regardless of HBV Genotype

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Journal of Clinical and Translational Hepatology 2022年第6期10卷 1068-1076页

作者： Luisa Roade Mar Riveiro-Barciela Adriana Palom Francisco Rodríguez-Frías Marta Bes Ariadna Rando María Teresa Salcedo Rosario Casillas Elena Vargas-Accarino David Tabernero Silvia Sauleda Rafael Esteban María Buti liver Unit Internal Medicine DepartmentHospital Universitari Vall d’HebronVall d’Hebron Barcelona Hospital CampusBarcelonaSpain Universitat Autònoma de Barcelona(UAB) Department of MedicineBarcelonaSpain Universitat Au-tònoma de Barcelona(UAB) Department of Biochemistry and Molecular BiologyBarcelonaSpain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas(CIBERehd) Instituto de Salud Carlos IIIMadridSpain liver Pathology Lab Biochemistry and Microbiology Departments(Clinical Laboratories)Hospital Universitari Vall d’HebronVall d’Hebron Barcelona Hospital CampusBarcelonaSpain Vall d’Hebron Institut de Recerca(VHIR) Liver Diseases GroupBarcelonaSpain Transfusion Safety Laboratory Banc de Sang i TeixitsServei Catalàde la SalutBarcelonaSpain De-partment of Pathology Hospital Universitari Vall d’HebronUniversitat Autònoma de BarcelonaBarcelonaSpain

Background and Aims:Hepatitis B virus(HBV)biomark-ers have been used for a better categorization of patients,even though the lack of simple algorithms and the impact of genotypes limit their *** aim was to assess the usefulness of noninvasive markers for the identification of HBV inactive carriers(ICs)in a single-point evaluation and to design a predictive model for their ***-ods:This retrospective-prospective study included 343 consecutive HBeAg-negative ***,analytical,and virological data were collected,and a liver biopsy was performed if *** were classified at the end of follow-up as ICs,chronic hepatitis B and gray zone.A pre-dictive model was constructed,and validated by 1000-boot-strap ***:After 39 months of follow-up,298 subjects were ICs,36 were chronic hepatitis B CHB,and nine were gray ***-nine(25.9%)individuals re-quired a liver *** HBV DNA hazard ratio(HR)6.0,pliver stiffness were in-dependently associated with the IC phase.A score including those variables identified ICs at a single-point evaluation,and might be applied to implement less intensive follow-up strategies.

关键词： Hepatitis B virus Inactive carrier liver stiffness HBV DNA Quan-titative HBsAg Core-related antigen.

Diagnostic role of transient elastography in patients with autoimmune liver diseases:A systematic review and meta-analysis

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World Journal of Gastroenterology 2023年第39期29卷 5503-5525页

作者： Hong Chen Yue Shen Sheng-Di Wu Qin Zhu Cheng-Zhao Weng Jun Zhang Mei-Xia Wang Wei Jiang Department of Gastroenterology and Hepatology Zhongshan Hospital(Xiamen)Fudan UniversityXiamen 361015Fujian ProvinceChina Department of Gastroenterology and Hepatology Zhongshan Hospital of Fudan UniversityShanghai 200032China Shanghai Institute of liver Diseases Fudan University Shanghai Medical CollegeShanghai 200032China

BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver ***,previous studies have focused primarily on chronic viral hepatitis and nonalcoholic fatty liver *** diagnostic value of transient elastography for autoimmune liver diseases(AILDs)is worth *** To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in *** The PubMed,Cochrane Library and EMBASE databases were *** evaluating the efficacy of noninvasive methods in the diagnosis of AILDs[autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)and primary sclerosing cholangitis(PSC)]were *** summary area under the receiver operating characteristic curve(AUROC),diagnostic odds ratio,sensitivity and specificity were used to assess the accuracy of these noninvasive methods for staging *** A total of 60 articles were included in this study,and the number of patients with AIH,PBC and PSC was 1594,3126 and 501,*** summary AUROC of transient elastography in the diagnosis of significant fibrosis,advanced fibrosis and cirrhosis in patients with AIH were 0.84,0.88 and 0.90,respectively,while those in patients with PBC were 0.93,0.93 and 0.91,*** AUROC of cirrhosis for patients with PSC was ***,other noninvasive indices(aspartate aminotransferase to platelet ratio index,aspartate aminotransferase/alanine aminotransferase ratio,fibrosis-4 index)had corresponding AUROCs less than *** Transient elastography exerts better diagnostic accuracy in AILD patients,especially in PBC *** appropriate cutoff values for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 and 14.4 to 16.9 KPa for PBC patients.

关键词： liver stiffness Serum parameter liver fibrosis Noninvasive diagnosis Transient elastography Autoimmune liver disease