Preliminary Resultshis series describes 2 patients whose early and accurate diagnosis of sinusoidal obstructive syndrome may have been responsible for their good clinical courses. The aim of this article is to report the acoustic radiation force (ARFI) impulse elastographic findings in both patients and the contrast-enhanced sonographic findings in one of these patients. To our knowledge, there are no previous reports on the ARFI elastographic or contrastenhanced sonographic features in this disease. Clinical data, B-mode findings, and spectral and color Doppler findings in both cases and multidetector row computed tomographic (CT) findings in one of them also contributed to the diagnosis.Teresa Fontanilla, MD, Concepción González Hernando, MD, Juan Cristóbal Valenzuela Claros, MD, Guiomar Bautista, MD, Javier Minaya, MD, Maria del Carmen Vega, MD, Ana Piazza, MD, Santiago Méndez, MD, Claudio Rodriguez, MD, Rafael Pérez Arangüena, MD Received March 31, 2011, from
CASE SERIESWe report quantitative liver acoustic radiation force impulse (ARFI) elastographic findings in 2 cases of sinusoidal obstructive syndrome and liver contrast-enhanced sonographic features in one of these cases. To our knowledge, findings in this condition from these techniques have not been reported previously. Acoustic radiation force impulse elastography showed median high shear wave velocities (case 1, 2.75 m/s; case 2, 2.58 m/s) that normalized after specific treatment for sinusoidal obstructive syndrome; therefore, ARFI elastography provided quantitative information that helped diagnose this condition as well as monitor the response to treatment. Contrast-enhanced sonographic findings in one of the cases showed patchy liver enhancement that correlated with the high-velocity patchy distribution on ARFI elastography in that case and enhanced multidetector row computed tomographic findings in the other case. This contrast-enhanced sonographic pattern progressively normalized during follow-up after specific treatment. The elastographic features in both cases and contrast-enhanced sonographic features in one of them contributed to early diagnosis and follow-up of sinusoidal obstructive syndrome in both patients. Further prospective studies are necessary to define the role of ARFI elastography and contrast-enhanced sonography in the early diagnosis and clinical follow-up of this condition.
