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Background and Aims: Dysplastic nodules are regenerative nodules but with atypical cells and they don't show clearly signs of malignancy. This study evaluates the usefulness of CEUS in the characterization of dysplastic nodules and early HCC. Methods and materials: 64 cirrhotic patients with 110 nodules no more than 2 cm were evaluated in Institute of Gastroenterology and Hepatology Iasi using CEUS with SonoVue and were analysed retrospectively. The CEUS findings were compared with clinical data and other dynamic contrast imaging such as CT and MRI Results: Enhancement patterns of all nodules were examined throughout the various vascular phases of CEUS and classified into 4 types. Type I, 47 (42.7%) nodules demonstrated simultaneous enhancement with the liver parenchyma and, therefore, the nodules appeared isoechoic to the liver throughout the arterial, portal and parenchymal phases. Type II, 29 (26.3%) nodules demonstrated delayed enhancement in the portal phase and then became isoechoic to the liver in parenchymal phase. Type III, 27 (24.5%) nodules presented delayed or simultaneous enhancement with the liver and then slight wash-out causing a hypoechoic appearance in the parenchymal phase. Type IV, 10 (9.09%) nodules presented slight enhancement with hyperechoic during arterial phase and slight wash-out with hypoechoic to the liver during the parenchymal phase. Type III and IV nodules (approximately 1/3) presented wash-out and could be mistakenly classified as malignant lesions. Conclusion: Contrast -enhanced ultrasound may be helpful in predicting the progress from dyplastic nodules to HCC. [ABSTRACT FROM AUTHOR]

Introduction and Aim: In recent years, liver biopsy was replaced by non-invasive methods in the assessment of hepatic fibrosis (transient elastography, real time elastography, FibroTest). The aim of this study was to test whether there is any connection between food intake and the assessment of liver stiffness (LS) measured by non-invasive methods (Fibroscan) in the case of HCV infected patients. Methods: We conducted a single-center retrospective study over a period of 2 years (January 2017 - January 2019). 66 patients with confirmed diagnosis of HCV infection which were evaluated in order to determine whether or not they qualify for the interferon free therapy and 25 healthy volunteers were enrolled in the study. Demographic, clinical characteristics and laboratory findings were collected from medical records. All patients included underwent Fibroscan. LS was measured before and 30 minutes after receiving a standard mixed solid meal. Results: 91 subjects (66 HCV patients/25 healthy volunteers) were included in the study. The mean BMI was 25.6 ± 4.5 kg/m2. In the HCV group, 52 had moderate fibrosis (F1-F3) and 14 cirrhosis (F4). LS significantly increased 30 min after food intake (pre-meal 9.1 kPa vs. after- meal 9.8 kPa; p < 0.001) in patients with HCV infection. There was no statistically significant difference in LS value measured before/after food intake in healthy volunteers. LS values increased after meals in all stages of fibrosis. Conclusions: Our study demonstrates that LS measured by Fibroscan increases after food intake in patients with HCV infection. An accurate assessment of LS is important in these patients because its value represents an inclusion criteria for DAA therapy, therefore its measurement should be performed in standardized fasting conditions. [ABSTRACT FROM AUTHOR]