1310: Transient Elastography (Fibroscan) in Hepatocellular Carcinoma Disease

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Ultrasound in Medicine and Biology

LDLT, and subsequently it enables the surgeon to make a timely and appropriate management. An awareness of detailed anatomicap map and IODS findings of various vascular complications, provided in this exhibit, are the prerequisites. 1309 Study of Doppler Ultrasonography Parameters in Assessment of Liver Fibrosis Stage in Patients with Chronic Viral Hepatites B and C Oxana N Konovalova, I.M. Sechenov Moscow Medical Academy, Russia Chavdar S Pavlov, I.M. Sechenov Moscow Medical Academy, Russia Vladimir T Ivashkin, I.M. Sechenov Moscow Medical Academy, Russia Objective: To estimate prognostic value of Doppler ultrasonography in diagnostics of severe liver fibrosis (F2-F4). Methods: One hundred patients with chronic hepatitis diagnosis: 62 % (HCVRNA ⫹) and 38 % (HBVDNA ⫹), mean age 44.9⫾14.0 years, M 55, F 45, were investigated at Vasilenko clinic of MMA. Liver fibrosis stage was assessed by METAVIR. The Doppler mode was used to measure diameter and velocity scores of portal (PV) and splenic veins (SV), common hepatic artery (CHA), splenic artery (SA) in celiac trunk area. Multifactor regression analysis of the most significant scores for revealing severe liver fibrosis was carried out. The selected parameters were studied by ROC-curves plotting. Patients were grouped according to the liver fibrosis stage (F0-F1) and (F2-F4). Statistical analysis was done at SPSS 16.0. Results: Multifactor regression analysis has revealed, that changes of mean velocity of PV blood flow (MVPV) and SA pulsatility index (SAPI) indicate the presence of severe liver fibrosis. ROC-curves analysis has revealed, that prognostic value of the area under the curve for SAPI at severe fibrosis is 84.3 % (AUROC 0.843; 95%-CI 0.755-0.930; p ⬍0.001). Prognostic value of area under the curve for MVPV at severe fibrosis was 69.5 % (AUROC 0.695; 95%-CI 0.591-0.820; p⫽0.001). Conclusions: Evaluation of MVPV and SAPI scores brings a convincing input in non-invasive diagnostics of severe liver fibrosis (F2-F4). Progression of fibrosis is accompanied by decrease of linear blood flow velocity in PV and increase of SV, CHA and SA diameters. 1310 Transient Elastography (Fibroscan) in Hepatocellular Carcinoma Disease Phuc Vinh Le Dinh, Medic Medical Center, HCMC Vietnam, Vietnam Hai Thanh Phan, Medic Medical Center, HCMC Vietnam, Vietnam Aims: FibroScan can predict liver fibrosis, which is closely correlated with the development of hepatocellular carcinoma. In many cases of liver tumour, we will make the wrong diagnosis in ultrasound. Our aim was to evaluate the correlation if FibroScan could be directed toward that tumour can be benign or else carcinoma in patients with viral hepatitis. Methods: Cross description 88 patients HCC was determined from June 2006 to October 2008. Group A was defined as patients who developed HCC with cirrhosis. Group B was defined as those with chronic hepatitis. Analyse FibroScan value, characteristics of liver tumour in B-mode ultrasound, AFP.Using t-test to find differentiate about median FS among groups. Results: This study enrolled 88 patients with hepatitis B and C virus related chronic liver disease (72 males, 16 females, median age 50,6 years). FibroScan: F4 (68 cases, mean FS: 47.3 KPa); F3 (14 cases, mean FS: 10.6 KPa); F2 (4 cases, mean FS: 7.6 KPa); F1 (2 cases; mean FS: 5.9 KPa). We realize median FS differed significantly between group A with group B (␣⫽ 0.05). Alternatively, median FS was not related with position of liver tumour (right lobe, left lobe or both); size of tumour (⬍2cm or ⬎⫽2cm); form of lesion; AFP value (⬍100ng/ml or ⬎⫽100ng/ml).

Volume 35, Number 8S, 2009 Conclusions: Our study suggest that liver stiffness measurement is a significant predictor of HCC development in patients with viral hepatitis. We offer all patients have liver tumours diagnosed on B-mode ultrasound to be performed FibroScan to evalue fibrosis stages. 1311 Diagnosis of Small Hepatocellular Carcinoma: Comparison of Low Mechanical Index Real-Time Contrast-Enhanced Ultrasonography with Contrast-Enhanced Helical CT Rui Li, Department of Ultrasound, Southwest Hospital, the Third Military Medical University, China Xiao hang Zhang, Department of Ultrasound, Southwest Hospital, the Third Military Medical University, China Xing Hua, Department of Ultrasound, Southwest Hospital, the Third Military Medical University, China Objective: To compare the efficacy of real-time contrast- enhanced ultrasonography for the diagnosis of small hepatocellular carcinoma(ⱕ2 cm) with contrast-enhanced CT. Methods: Low mechanical index (MI⬍0.19) real-time pulse-inversion harmonic SonoVue enhanced ultrasonography and contrast-enhanced helical CT were performed on 117 patients with small hepatocellular carcinoma[95 men and 22 women, age range 23⬃75 years, size of the nodules range 0.5⬃2.0 cm, mean size (1.43⫾0.34) cm]before operation or biopsy. The diagnostic performance was calculated by using histologic results as the reference standards. Results: Eleven cases were overlooked by contrast- enhanced ultrasonography and 27 cases were missed by contrast-enhanced CT. The detection rate of small HCC was 90.6 %(106/117) for contrast-enhanced ultrasonography and 76.9%(90/117) for contrast-enhanced CT (P⬍0.01). Taking hypervascular during arterial phase and washout during portal or late phase as the diagnostic criteria, overall diagnostic accuracy was 80.2%(85/106) for contrast- enhanced ultrasonography and 65.6%(59/90) for contrast-enhanced helical CT (P⬍0.05). Conclusion: Contrast-enhanced ultrasonography is superior to contrast-enhanced helical CT in detection and characterization of ⱕ2 cm small hepatocellular carcinoma and has high clinical value in patients whose contrast-enhanced CT scanning were negative. 1312 Ultrasonic Appearances of the Types of Portal Vein Tumor Thrombosis in Hepatocellular Carcinoma Liwu Lin, Dept. of Ultrasound of Union Hospital of Fujian Medical University, China Jiajia Yang, Dept. of Ultrasound of Union Hospital of Fujian Medical University, China Ensheng Xue, Dept. of Ultrasound of Union Hospital of Fujian Medical University, China Objective: To probe the incidence rates and ultrasonic performances of various types of portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC). Methods: Ultrasonography was carried out for 178 patients with HCC. Typing determinations were made for the PVTT cases and ultrasonic performances of each type were analyzed. Statistical analysis was taken to compare the differences of PVTT incidence rates and type ratios among HCC groups. Results: PVTT was found in 64 cases(type I in 25, type II in 31, type III in 8) among 178 HCC patients. The arterial flow signals were detected in 87.18% of type II and III, and slightly hyperechoic or hypoechoic strip-like area were found in type I cases. No significant difference of PVTT type ratios was found among different groups(P⬎0.05),while significant differences of PVTT incidence rates among groups with different sizes were noticed (P⬍0.05).