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4. Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

Author

Bob, Flaviu, Grosu, Iulia, Sporea, Ioan, Timar, Romulus, Lighezan, Daniel, Popescu, Alina, Sirli, Roxana, Buzas, Roxana, Petrica, Ligia, Munteanu, Mircea, and Schiller, Adalbert

Abstract

Studies published so far using ultrasound-based elastography in the kidneys, lack to prove a clear relationship between kidney shear wave speed (KSWS) and renal disease progression. Taking into account that the kidney is a highly vascularized organ, the present study aims to find a relationship between KSWS and vascular factors (blood pressure [BP], arterial stiffness). Our study included 38 diabetic kidney disease patients (mean age 56.52 ± 16.12 years, 19 female, 19 male). KSWS, an indicator of renal stiffness, was measured using point Shear Wave Elastography (pSWE; Siemens Acuson S2000). In every patient, we recorded BP, and we measured aortic augmentation index (AAI) and brachial pulse wave velocity (PWV), using oscillometry. We found statistically significant indirect correlations of KSWS with indicators of arterial stiffness, such as PWV (r= –.41, p= .036), and AAI (r= –.37, p= .031). We found also an indirect correlation of KSWS with diastolic BP (r= –.65, p= .02) and systolic BP (r= –.54, p= .008). We found no correlation of KSWS with estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio, stage of diabetic retinopathy, or glycated hemoglobin. Our study shows that high BP and the progression of arteriosclerosis (high PWV and AAI), leads to a decrease of renal stiffness. Thus, it seems that KSWS is influenced by renal blood flow, rather than other factors, such as albuminuria or chronic kidney disease stage.

Published
2018
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6. The influence of aminotransferase levels on liver stiffness assessed by Acoustic Radiation Force Impulse Elastography: A retrospective multicentre study.

Author

Bota, Simona, Sporea, Ioan, Peck-Radosavljevic, Markus, Sirli, Roxana, Tanaka, Hironori, Iijima, Hiroko, Saito, Hidetsugu, Ebinuma, Hirotoshi, Lupsor, Monica, Badea, Radu, Fierbinteanu-Braticevici, Carmen, Petrisor, Ana, Friedrich-Rust, Mireen, Sarrazin, Christoph, Takahashi, Hirokazu, Ono, Naofumi, Piscaglia, Fabio, Marinelli, Sara, D’Onofrio, Mirko, and Gallotti, Anna

Abstract

Abstract: Background: Acoustic Radiation Force Impulse Elastography is a new method for non-invasive evaluation of liver fibrosis. Aim: To evaluate the impact of elevated alanine aminotransferase levels on liver stiffness assessment by Acoustic Radiation Force Impulse Elastography. Methods: A multicentre retrospective study including 1242 patients with chronic liver disease, who underwent liver biopsy and Acoustic Radiation Force Impulse. Transient Elastography was also performed in 512 patients. Results: The best Acoustic Radiation Force Impulse cut-off for predicting significant fibrosis was 1.29m/s in cases with normal alanine aminotransferase levels and 1.44m/s in patients with alanine aminotransferase levels>5× the upper limit of normal. The best cut-off for predicting liver cirrhosis were 1.59 and 1.75m/s, respectively. Acoustic Radiation Force Impulse cut-off for predicting significant fibrosis and cirrhosis were relatively similar in patients with normal alanine aminotransferase and in those with alanine aminotransferase levels between 1.1 and 5× the upper limit of normal: 1.29m/s vs. 1.36m/s and 1.59m/s vs. 1.57m/s, respectively. For predicting cirrhosis, the Transient Elastography cut-offs were significantly higher in patients with alanine aminotransferase levels between 1.1 and 5× the upper limit of normal compared to those with normal alanine aminotransferase: 12.3kPa vs. 9.1kPa. Conclusion: Liver stiffness values assessed by Acoustic Radiation Force Impulse and Transient Elastography are influenced by high aminotransferase levels. Transient Elastography was also influenced by moderately elevated aminotransferase levels. [Copyright &y& Elsevier]

Published
2013
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9. Contrast-enhanced ultrasound assessment of focal liver lesions with SonoVue®

Author

Sporea, Ioan and Sirli, Roxana

Abstract

Focal liver lesions are frequently discovered in daily practice owing to extensive use of imaging methods. Their nature must be elucidated for prognosis assessment and to decide upon therapeutic strategy. Contrast-enhanced ultrasonography with perfluoro-containing contrast agents is an imaging technique developed in recent years, with a similar performance to contrast CT and contrast MRI in focal liver lesions diagnosis, but it is less expensive and without the risk of ionizing radiation. It is a real-time method, thus allowing for rapid diagnosis using low mechanical index ultrasound waves. The vascularity and enhancement pattern of the lesion (hypo-, hyper- or iso-echoic) as compared with the adjacent liver parenchyma during the arterial, portal venous and late phases are evaluated for contrast-enhanced ultrasonography characterization.

Published
2012
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11. Controlled Attenuation Parameter for Quantification of Steatosis: Which Cut-Offs to Use?

Author

Sirli, Roxana and Sporea, Ioan

Abstract

Chronic liver diseases (CLDs) are a public health problem, even if frequently they are underdiagnosed. Hepatic steatosis (HS), encountered not only in nonalcoholic fatty liver disease (NAFLD) but also in chronic viral hepatitis, alcoholic liver disease, etc., plays an important role in fibrosis progression, regardless of CLD etiology; thus, detection and quantification of HS are imperative. Controlled attenuation parameter (CAP) feature, implemented in the FibroScan® device, measures the attenuation of the US beam as it passes through the liver. It is a noninvasive technique, feasible and well accepted by patients, with lower costs than other diagnostic techniques, with acceptable accuracy for HS quantification. Multiple studies have been published regarding CAP performance to quantify steatosis, but due to the heterogeneity of CLD etiologies, of steatosis prevalence, etc., it had widely variable calculated cut-off values, which in turn limited the day-to-day utility of CAP measurements in clinical practice. This paper reviews published studies trying to suggest cut-off values usable in clinical practice.

Published
2021
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12. Sa1540 - Prospective Analysis of Discordant Results Between Fibromax® and Fibroscan® in Patients with HCV Compensated Liver Cirrhosis before 3D Antiviral Therapy Initiation.

Author

Gheorghe, Liliana, Iacob, Speranta, Prelipcean, Cristina Cijevschi, Trifan, Anca, Stanciu, Carol, Sporea, Ioan, Sirli, Roxana, Curescu, Manuela, Brisc, Ciprian, Mihai, Catalina, Alexandrescu, Luana, Sandulescu, Larisa D., Goldis, Adrian, Arama, Victoria, Caruntu, Florin, Hara, Livia, Rogoveanu, Ion, Diculescu, Mircea, Gheorghe, Cristian, and Seicean, Andrada

Published
2017
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13. Tu1544 - Predictors of Liver Stiffness Regression after SVR in Cirrhotic Patients Treated with 3D Regimen.

Author

Iacob, Speranta, Gheorghe, Liliana, Prelipcean, Cristina Cijevschi, Trifan, Anca, Stanciu, Carol, Sporea, Ioan, Sirli, Roxana, Curescu, Manuela, Brisc, Ciprian, Mihai, Catalina, Alexandrescu, Luana, Sandulescu, Larisa D., Goldis, Adrian, Arama, Victoria, Caruntu, Florin, Hara, Livia, Rogoveanu, Ion, Diculescu, Mircea, Iacob, Razvan, and Gheorghe, Cristian

Published
2017
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24. Tu1024 Which Elastographic Method (Transient Elastography or ARFI) is More Useful for Liver Fibrosis Evaluation in Patients With Chronic Hepatitis C? - an International Multicenter Study.

Author

Sporea, Ioan, Bota, Simona, Sirli, Roxana, Badea, Radu, Lupsor, Monica, Saito, Hidetsugu, Ebinuma, Hirotoshi, Friedrich-Rust, Mireen, Sarrazin, Christoph, Piscaglia, Fabio, Borghi, Alberto, Ferlitsch, Arnulf, Peck-Radosavljevic, Markus, Popescu, Alina, and Danila, Mirela

Published
2012
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25. Tu1023 Is Acoustic Radiation Force Impulse Elastography (ARFI) a Useful Method for Noninvasive Fibrosis Evaluation in Patients With Chronic Hepatitis C? - an International Multicenter Study.

Author

Sporea, Ioan, Bota, Simona, Sirli, Roxana, Tanaka, Hironori, Iijima, Hiroko, Badea, Radu, Lupsor, Monica, Braticevici, Carmen Fierbinteanu, Petrisor, Ana, Saito, Hidetsugu, Ebinuma, Hirotoshi, Friedrich-Rust, Mireen, Sarrazin, Christoph, Takahashi, Hirokazu, Ono, Naofumi, Piscaglia, Fabio, Borghi, Alberto, D'Onofrio, Mirko, Gallotti, Anna, and Peck-Radosavljevic, Markus

Published
2012
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26. Tu1022 Is the Correlation of Liver Stiffness Assessed by Acoustic Radiation Force Impulse Elastography (ARFI) Influenced by the Aminotransferases Level? - an International Multicenter Study.

Author

Bota, Simona, Sporea, Ioan, Sirli, Roxana, Tanaka, Hironori, Iijima, Hiroko, Badea, Radu, Lupsor, Monica, Braticevici, Carmen Fierbinteanu, Petrisor, Ana, Saito, Hidetsugu, Ebinuma, Hirotoshi, Friedrich-Rust, Mireen, Sarrazin, Christoph, Takahashi, Hirokazu, Ono, Naofumi, Piscaglia, Fabio, Borghi, Alberto, D'Onofrio, Mirko, Gallotti, Anna, and Peck-Radosavljevic, Markus

Published
2012
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