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Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy
Author(s) -
Nanashima Atsushi,
Sakamoto Ayami,
Sakamoto Ichiro,
Hayashi Hideyuki,
Abo Takafumi,
Wakata Kouki,
Murakami Goushi,
Arai Junichi,
Wada Hideo,
Takagi Katsunori,
Takeshita Hiroaki,
Hidaka Shigekazu,
To Kazuo,
Nagayasu Takeshi
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12306
Subject(s) - medicine , cirrhosis , elastography , ascites , indocyanine green , acoustic radiation force , receiver operating characteristic , hepatic fibrosis , hepatectomy , transient elastography , fibrous capsule of glisson , liver function , ultrasound , radiology , fibrosis , mechanical index , liver tumor , hepatocellular carcinoma , liver fibrosis , pathology , surgery , resection , microbubbles
Aim To evaluate hepatic fibrosis and tumor diagnosis preoperatively, we investigated the elasticity calculated by the new parameter of ultrasonography, acoustic radiation force impulse ( ARFI ). Methods We examined ARFI of the non‐tumorous right and left lateral liver and in the tumor by push pulse of probe in 95 patients with hepatic malignancies undergoing hepatectomy. Measurement of ARFI as hepatic stiffness was indicated as the V s (m/s). Results Measuring the V s in the non‐tumor region was achieved in the right liver in 99% and at the left lateral liver in 94%. The V s in the right liver was significantly lower than in the left lateral liver, and the V s of the liver tumor was significantly higher than in the non‐tumorous liver. The V s in the right and left lateral liver was correlated with the platelet count, aspartate aminotransferase, fibrotic indices and indocyanine green test. The V s in the right liver was significantly correlated with the fibrotic marker or index. The V s of liver cirrhosis and histological stage 4 in the right and left liver was significantly the highest compared to the others. The V s in the right liver showed a high area under the receiver–operator curve value predicting histological fibrosis. The V s in the right was significantly correlated with blood loss and postoperative complications, particularly uncontrolled ascites. Conclusion Non‐invasive ARFI imaging elastography is useful in evaluating impaired liver function or in the differential diagnosis of liver malignancies, highly hepatic fibrosis and in predicting posthepatectomy morbidity.