Regenerating nodules in cirrhosis: sonographic appearance with anatomic correlation

Freeman, M. P.; Vick, C. Whitley; Taylor, K. J. W.; Carithers, RL; Brewer, W H

doi:10.2214/ajr.146.3.533

Cited by 46 publications

(14 citation statements)

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“…These results are partly explained by the limited portions of the liver that can be explored with high-frequency probes in vivo. Not even the presence of ascites (which could reproduce the water bath used in the experimental conditions by Freeman et al 13 ) facilitated the US recognition of IRNs: indeed, high~ frequency transducers disclosed focal lesions in only 1 out of 20 ascitic patients.…”

Section: Discussionmentioning

confidence: 99%

“…13 Two patients were initially evaluated with a 3-MHz sector probe. In the same session, high-frequency transducers were sequentially employed as they were available in the department during the study time period: 5-and 7.5-MHz linear probes in 35 cases and in all of the controls; 5-and 7.5· MHz sector transducers in the remaining three patients with cirrhosis.…”

Section: Methodsmentioning

confidence: 99%

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Sonographic recognition of intraparenchymal regenerating nodules using high-frequency transducers in patients with cirrhosis.

Giorgio

Francica

Stefano

et al. 1991

Journal of Ultrasound in Medicine

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In 38 patients with cirrhotic liver, an ultrasound examination was carried out by using 3/3.5‐, 5‐, and 7.5‐MHz transducers sequentially in order to identify hypoechoic intraparenchymal regenerating nodules less than or equal to 20 mm. Twenty healthy subjects and 35 patients with noncirrhotic chronic liver disease were scanned as controls. Focal lesions were disclosed in five patients: one case turned out to be a small hepatocellular carcinoma; regenerating nodules were diagnosed as such in four cases by means of surgery, laparoscopy, and fine needle biopsy. At a follow‐up needle biopsy one year later, one of these nodules proved to be malignant. Use of high‐frequency transducers offered little aid to the diagnosis of small nodules. In only one case were multiple lesions revealed with a 7.5‐MHz probe but not with 3‐ and 5‐MHz probes. It seems that intraparenchymal regenerating nodules are rarely seen with the available technology, and their recognition cannot be recommended as a reliable ultrasound diagnostic marker of liver cirrhosis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Sonographic recognition of intraparenchymal regenerating nodules using high-frequency transducers in patients with cirrhosis.

Giorgio

Francica

Stefano

et al. 1991

Journal of Ultrasound in Medicine

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“…The image characteristics for evaluating hepatic fibrosis/cirrhosis are the nodular liver parenchyma, heterogeneous internal echo texture, decrease in the volume of right hepatic lobe and increase in the volume of caudate and left hepatic lobe, and the narrowing of the hepatic vein [19,20]. However, staging of the liver fibrosis using these characteristics is less reliable since the appearance of images can be changed due to differences in ultrasonic power and/or the image settings of the equipment used.…”

Section: Introductionmentioning

confidence: 99%

Novel Image Analysis Method Using Ultrasound Elastography for Noninvasive Evaluation of Hepatic Fibrosis in Patients with Chronic Hepatitis C

Fujimoto¹,

Kato

Kudo

et al. 2013

Oncology

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It has been established that the long-term infection of chronic hepatitis C leads to the increased risk of hepatic fibrosis and hepatocellular carcinoma. Currently, histological diagnosis by invasive and painful liver biopsy is the gold standard for evaluating the hepatic fibrosis stage. Because of a side effect or patient inability to cope with the pain, it is difficult to assess the fibrosis stage frequently using liver biopsy. Recently, instead of liver biopsy, many articles have been published showing the usefulness of ultrasound elastography to evaluate the stage of hepatic fibrosis. We also reported the usefulness of real-time tissue elastography (RTE) for liver fibrosis staging in 2007. However, in our previous report, fibrosis classification was performed manually and the number of patients involved was also small. In the current study, the fibrosis staging is performed automatically using software by characterizing the elastography images. We have also increased the number of patients from 64 to 310. Thus, the aim of this study is to increase objectivity by using a newly developed automatic analysis method. We obtain the Liver Fibrosis Index (LFI), which is calculated from image features of RTE images, using multiple regression analysis performed on clinical data of 310 cases as the training data set. The correlation coefficient obtained between the LFI and the stage of hepatic fibrosis was r = 0.68, and significant differences exist between all stages of fibrosis (p < 0.001). Our new method seems promising since it has the ability to diagnose fibrosis even in the presence of inflammation.

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“…24 The accuracy for the diagnosis of fibrosis/ cirrhosis usually is not as high as that for steatosis.25-28 We agree with Garra, Parker, and Tay In qualitative clinical studies on the influence of connective tissue on echogenicity and ultrasound image brightness, there is no agreement. [4][5][6]25,27,30,31 In the literature often there is no distinction made between alcoholic fatty cirrhosis and liver cirrhosis without fatty infiltration, as in posthepatitis or primary biliary cirrhosis. For this reason it is likely that the characteristic pattern seen, namely increased echogenicity, high attenuation, and image brightness, often is produced by fat clusters within a cirrhotic liver and not by connective tissue.…”

Section: Discussionmentioning

confidence: 99%

Computerized ultrasound B‐scan texture analysis of experimental diffuse parenchymal liver disease: Correlation with histopathology and tissue composition

Layer

Zuna

Lorenz

et al. 1991

J of Clinical Ultrasound

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By means of statistical pattern recognition procedures, a quantitative description of the ultrasound B-scan images of experimental diffuse liver disease has been carried out. Fatty livers, fatty fibrosis/cirrhosis, and cirrhosis without fatty infiltration of the liver were studied in female Wistar rats. Separation accuracies of more than 80% between the tissue classes "normal" vs "fatty infiltration," or "normal" vs "fatty cirrhosis," using only two statistical image parameters were found. A subclassification of the diffuse parenchymal liver disease was not possible. It is shown by multiple linear regression analysis that the image parameter "mean grey level" correlates better with total lipid content than with the amount of connective tissue. Furthermore it is demonstrated that connective tissue leads only to a weak increase in "mean grey level," whereas the addition of connective tissue to a given tissue lipid can lead to a reduction in image brightness.

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Regenerating nodules in cirrhosis: sonographic appearance with anatomic correlation

Cited by 46 publications

References 0 publications

Sonographic recognition of intraparenchymal regenerating nodules using high-frequency transducers in patients with cirrhosis.

Sonographic recognition of intraparenchymal regenerating nodules using high-frequency transducers in patients with cirrhosis.

Novel Image Analysis Method Using Ultrasound Elastography for Noninvasive Evaluation of Hepatic Fibrosis in Patients with Chronic Hepatitis C

Computerized ultrasound B‐scan texture analysis of experimental diffuse parenchymal liver disease: Correlation with histopathology and tissue composition

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