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Ostadmohammadi V, Namazi MJ, Rezasoltani M, Kheirkhah D, Rajabi M, Sharif A, Taghavi Ardakani A, Raygan F, Assareh AA, Sharif MR. Effects of Zinc Supplementation on Inflammatory Status and Nonalcoholic Steatohepatitis in Overweight or Obese Children: a Randomized Clinical Trial. Biol Trace Elem Res 2024; 202:3496-3503. [PMID: 37989929 DOI: 10.1007/s12011-023-03954-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
The purpose of the present clinical trial was to determine the impact of zinc supplementation on serum liver enzymes, steatosis severity, lipid profile, and inflammatory status in overweight or obese children with nonalcoholic steatohepatitis (NASH). This randomized controlled trial was conducted by enrolling 60 children with NASH, aged 10-18 years old. The participants were randomly assigned to two groups that received either 30 mg/day of elemental zinc or placebo for 16 weeks. The severity of liver steatosis was evaluated using liver ultrasonography. Fasting blood samples were collected from each patient at the beginning and after 16 weeks of intervention to measure biochemical parameters. Following a 16-week intervention, zinc supplementation compared with placebo significantly decreased serum alanine aminotransferase (ALT) concentrations and high-sensitivity C-reactive protein and considerably enhanced HDL-cholesterol values. However, zinc intake had no considerable impact on aspartate aminotransferase, the severity of liver steatosis, anthropometric parameters, and other lipid indices versus the placebo group. Overall, zinc supplementation showed a promising impact on serum ALT, HDL-cholesterol, and inflammatory status in overweight or obese children suffering from NASH. Zinc supplementation may be a new strategy for the amelioration of NASH in overweight or obese children. This trial has been registered on the Iranian website for registration of clinical trials with the special ID of IRCT20200531047614N1 ( https://www.irct.ir/trial/48543 ).
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Affiliation(s)
- Vahidreza Ostadmohammadi
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
- Clinical Research Development Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran.
| | - Mohammad Javad Namazi
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Sciences and Social Work, Western Illinois University, Macomb, USA
- School of Medicine, Islamic Azad Medical University, Tehran, Iran
| | - Mahsa Rezasoltani
- Clinical Research Development Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
- School of Medicine, Islamic Azad Medical University, Tehran, Iran
| | - Davood Kheirkhah
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Rajabi
- Department of Pediatrics, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Sharif
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Abbas Taghavi Ardakani
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Fariba Raygan
- Clinical Research Development Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Amelia A Assareh
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Mohammad Reza Sharif
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
- Clinical Research Development Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran.
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Yu P, Yang H, Li H, Mei Y, Wu Y, Cheng H, Su H, Deng Y, Jiang T, He Z, Hu P. Sigmoidal relationship between liver fat content and nonalcoholic fatty liver disease in Chinese adults. Postgrad Med J 2024; 100:562-568. [PMID: 38439557 DOI: 10.1093/postmj/qgae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE To explore the relationship between liver fat content (LFC) and nonalcoholic fatty liver disease (NAFLD) and determine the new threshold of LFC to diagnose NAFLD. METHODS The data from questionnaire survey, general physical examination, laboratory examination, and image examination were collected. Multivariate regression analysis, receiver operating characteristic curve analysis, smooth curve fitting, and threshold effect analysis were performed using the R software to investigate the relationship between LFC and NAFLD and to identify the new threshold of LFC to diagnose NAFLD. RESULTS The prevalence of NAFLD was 30.42%, with a significantly higher prevalence in men than in women. Regression analyses demonstrated that LFC odds ratio [95% confidence interval (CI)] was 1.28 (95% CI: 1.24-1.31) in fully-adjust model. Analysis of the LFC quartile, with Q1 as a reference, revealed that the odds ratios of NAFLD were 1.47 (95% CI: 1.08-1.99), 2.29 (95% CI: 1.72-3.06), and 10.02 (95% CI: 7.45-13.47) for Q2, Q3, and Q4 groups, respectively. Smooth curve fitting and threshold effect analysis displayed a nonlinear relationship between LFC and NAFLD, and the threshold was 4.5%. The receiver operating characteristic curve indicated that when LFC was 4.5%, the area under curve (95% CI) was 0.80 (0.79-0.82), and the sensitivity and specificity of LFC in diagnosing NAFLD were 0.64% and 0.82%, respectively. CONCLUSION The relationship between LFC and NAFLD was sigmoidal, with an inflection point of 4.5%.
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Affiliation(s)
- Pingping Yu
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
- Department of Infectious Diseases, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Huachao Yang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Hu Li
- Department of Infectious Diseases, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Ying Mei
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yuanyuan Wu
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Hongfeng Cheng
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Huiru Su
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yueling Deng
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Tao Jiang
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Zhongxiang He
- Health Medical Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Peng Hu
- Department of Infectious Diseases, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Yuan Y, Xu M, Zhang X, Tang X, Zhang Y, Yang X, Xia G. Development and validation of a nomogram model for predicting the risk of MAFLD in the young population. Sci Rep 2024; 14:9376. [PMID: 38654043 DOI: 10.1038/s41598-024-60100-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
This study aimed to develop and validate a nomogram model that includes clinical and laboratory indicators to predict the risk of metabolic-associated fatty liver disease (MAFLD) in young Chinese individuals. This study retrospectively analyzed a cohort of young population who underwent health examination from November 2018 to December 2021 at The Affiliated Hospital of Southwest Medical University in Luzhou City, Sichuan Province, China. We extracted the clinical and laboratory data of 43,040 subjects and randomized participants into the training and validation groups (7:3). Univariate logistic regression analysis, the least absolute shrinkage and selection operator regression, and multivariate logistic regression models identified significant variables independently associated with MAFLD. The predictive accuracy of the model was analyzed in the training and validation sets using area under the receiver operating characteristic (AUROC), calibration curves, and decision curve analysis. In this study, we identified nine predictors from 31 variables, including age, gender, body mass index, waist-to-hip ratio, alanine aminotransferase, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, and smoking. The AUROC for the subjects in the training and validation groups was 0.874 and 0.875, respectively. The calibration curves show excellent accuracy of the nomogram. This nomogram which was based on demographic characteristics, lifestyle habits, anthropometrics, and laboratory data can visually and individually predict the risk of developing MAFLD. This nomogram is a quick and effective screening tool for assessing the risk of MAFLD in younger populations and identifying individuals at high risk of MAFLD, thereby contributing to the improvement of MAFLD management.
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Affiliation(s)
- Yi Yuan
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Muying Xu
- The People's Hospital Of Luzhou, Luzhou, 646000, Sichuan, China
| | - Xuefei Zhang
- Department of Health Management Center, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xiaowei Tang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yanlang Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xin Yang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Guodong Xia
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
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Weimer JM, Beer D, Schneider C, Yousefzada M, Gottwald M, Züllich TF, Weimer A, Jonck C, Buggenhagen H, Kloeckner R, Merkel D. Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices-A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care. Diagnostics (Basel) 2023; 14:54. [PMID: 38201363 PMCID: PMC10795594 DOI: 10.3390/diagnostics14010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is limited evidence regarding potential variations in B-scan quality among HHUS devices from various manufacturers, and regarding whether any such differences hold clinical significance in intensive care medicine settings. METHODS this study included the evaluation of eight HHUS devices sourced from diverse manufacturers. Ultrasound videos of five previously defined sonographic questions (volume status/inferior vena cava, pleural effusion, pulmonary B-lines, gallbladder, and needle tracking in situ) were recorded with all devices. The analogue recording of the same pathologies with a HEUS device served as gold standard. The corresponding findings (HHUS and HEUS) were then played side by side and evaluated by sixteen intensive care physicians experienced in sonography. The B-scan quality and the clinical significance of the HHUS were assessed using a five-point Likert scale (5 points = very good; 1 point = insufficient). RESULTS both in assessing the quality of B-scans and in their ability to answer clinical questions, the HHUS achieved convincing results-regardless of the manufacturer. For example, only 8.6% (B-scan quality) and 9.8% (clinical question) of all submitted assessments received an "insufficient" rating. One HHUS device showed a significantly higher (p < 0.01) average points score in the assessment of B-scan quality (3.9 ± 0.65 points) and in the evaluation of clinical significance (4.03 ± 0.73 points), compared to the other devices. CONCLUSIONS HHUS systems are able to reliably answer various clinical intensive care questions and are-while bearing their limitations in mind-an acceptable alternative to conventional HEUS devices. Irrespective of this, the present study was able to demonstrate relevant differences in the B-scan quality of HHUS devices from different manufacturers.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (C.J.); (H.B.)
| | - Diana Beer
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
| | - Christoph Schneider
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
| | - Masuod Yousefzada
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
| | - Michael Gottwald
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
| | - Tim Felix Züllich
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 69118 Heidelberg, Germany;
| | - Christopher Jonck
- Rudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (C.J.); (H.B.)
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (C.J.); (H.B.)
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein—Campus Lübeck, 23538 Lübeck, Germany;
| | - Daniel Merkel
- Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany; (D.B.); (C.S.); (M.Y.); (M.G.); (T.F.Z.)
- BIKUS—Brandenburg Institute for Clinical Ultrasound, Brandenburg Medical School Theodor Fontane (MHB), 16816 Neuruppin, Germany
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Karlas T, Blank V, Trenker C, Ignee A, Dietrich CF. [Ultrasound systems for abdominal diagnostics - current methods, clinical applications and new technologies]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1235-1245. [PMID: 36634681 DOI: 10.1055/a-1993-5356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Abdominal ultrasound is the method of first choice in many clinical situations. Gray scale imaging (B-mode) and conventional Doppler techniques are nowadays complemented by contrast-enhanced ultrasound (CEUS), elastography, fat quantification and further technologies which allow multimodal characterization of organs and tissue structure using panoramic imaging, 3D-techniques and image fusion. The development of small portable devices augments the spectrum for sonographic diagnostics. In this review, we describe the current status of ultrasound technology based on published evidence. In addition, we provide guidance for quality assurance.
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Affiliation(s)
- Thomas Karlas
- Medizinischen Klinik 2, Bereich Gastroenterologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Valentin Blank
- Medizinischen Klinik 2, Bereich Gastroenterologie, Universitätsklinikum Leipzig, Leipzig, Germany
- Klinik für Innere Medizin I (Gastroenterologie, Pneumologie) und Interdisziplinäre Ultraschallabteilung, Universitätsklinikum Halle (Saale), Halle, Germany
| | - Corinna Trenker
- Klinik für Hämatologie, Onkologie und Immunologie, Universitätsklinikum Marburg, Marburg, Germany
| | - André Ignee
- Medizinische Klinik mit Schwerpunkt Gastroenterologie & Rheumatologie, Klinikum Würzburg Mitte gGmbH Standort Juliusspital, Wurzburg, Germany
| | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Teufel A, Geier A, Sarrazin C, Schattenberg JM, Kautz A, Dorner R, Kramer J, Jerysiak K, Baars T, Hönscheid B, Müller-Wieland D, Rossol S, Trautwein C, Tacke F, Canbay A. [Intersectoral management of patients with abnormal liver enzymes and non-alcoholic fatty liver disease (NAFLD)]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1028-1036. [PMID: 36791784 PMCID: PMC10421697 DOI: 10.1055/a-1957-5671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/22/2022] [Indexed: 02/17/2023]
Abstract
The prevalence of fatty liver disease has increased significantly in Germany in recent years. With an estimated 18 million German citizens being affected, it is now among the most prevalent diseases. Furthermore, it is also considered a relevant and independent risk factor for other common cardiovascular diseases such as heart attack or stroke. Finally, diabetes mellitus promotes the development of and an unfavorable course of fatty liver disease. Given the high prevalence and complications, the German healthcare system is reaching its limits.Therefore, close coordination of all healthcare providers and specialists involved in the treatment of these patients is essential. In an expert consensus involving private practice and hospital doctors from the fields of gastroenterology, endocrinology, cardiology, general practitioners and laboratory physicians, as well as in close coordination with patient representatives, we have designed a concept for the care of these patients in the German healthcare system. Necessary developments are also addressed. In addition to being useful as a practical guideline, this should also support health policy work, especially in the development of practical care solutions at the medical level.
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Affiliation(s)
- Andreas Teufel
- Sektion Hepatologie, Sektion Klinische Bioinformatik, II. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim
- Medizinische Fakultät Mannheim, Klinische Kooperationseinheit Healthy Metabolism, Zentrum für Präventionsmedizin und Digitale Gesundheit Baden-Württemberg, Universität Heidelberg, Mannheim
| | - Andreas Geier
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg
| | | | | | | | | | - Jan Kramer
- Medizinische Klinik I, Universität zu Lübeck, Lübeck, Germany
- LADR Der Laborverbund Dr. Kramer & Kollegen, Geesthacht
| | | | - Theodor Baars
- Praxis für Innere Medizin, Kardiologie, Notfallmedizin, Sportmedizin, hausärztliche Versorgung, Essen
| | | | | | | | | | - Frank Tacke
- Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Campus Virchow-Klinikum (CVK) und Campus Charité Mitte (CCM), Charité Universitätsmedizin Berlin, Berlin
| | - Ali Canbay
- Ruhr-Universität Bochum, Medizinische Klinik, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum
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Sun L, Li N, Zhang L, Chen J. The Role of ElastPQ in Assessing Liver Stiffness for Non-Alcoholic Fatty Liver Disease in Patients Treated with Atypical Antipsychotic Drugs. Neuropsychiatr Dis Treat 2023; 19:1491-1502. [PMID: 37408709 PMCID: PMC10319346 DOI: 10.2147/ndt.s409210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
Objective To evaluate the role of elastography point quantification (ElastPQ) for the quantitative assessment of stiffness in the fatty liver disease in mental disorder patients and to provide a noninvasive detection method for non-alcoholic fatty liver (NAFLD) caused by atypical antipsychotics drugs (AAPDs). Methods A total number of 168 mental disorder patients treated with AAPDs and 58 healthy volunteers were enrolled in this study. All the subjects underwent ultrasound and ElastPQ tests. The basic data of the patients were analyzed. Results BMI, liver function, and the value of ElastPQ were considerably higher in the patient group than that in the healthy volunteers. The values of liver stiffness obtained by ElastPQ were increased gradually from 3.48(3.14-3.81) kPa in the normal liver to 8.15(6.44-9.88) in the severe fatty liver. The receiver operating characteristic (ROC) for the diagnosis of fatty liver with ElastPQ were 0.85, 0.79, 0.80, and 0.87 for the diagnosis of normal, mild, moderate, and severe steatosis, respectively, with a sensitive/specificity of 79%/76.4%, 85.7%/78.3%, 86.2%/73%, and 81.3%/82.1%, correspondingly. Moreover, ElastPQ in the olanzapine group was higher than those in the risperidone and aripiprazole groups (5.11(3.83-5.61) kPa vs 4.35(3.63-4.98) kPa, P < 0.05; 5.11(3.83-5.61) kPa vs 4.79(4.18-5.24) kPa, P < 0.05). After one-year treatment, the value of ElastPQ was 4.43(3.85-5.22) kPa, but it was 5.81(5.09-7.33) kPa in patients treated for more than three years. This value increased with treatment prolongation (P < 0.05). Conclusion ElastPQ is a real-time, quantitative method for assessing the stiffness of NAFLD. The liver stiffness value could be varied in the different stages of fatty liver. Olanzapine has a considerable influence on liver stiffness. The long-term use of AAPDs can increase the stiffness value of fatty liver.
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Affiliation(s)
- Linlin Sun
- Department of Ultrasound, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Nan Li
- Department of Ultrasound, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Ligang Zhang
- Department of Psychiatry, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Jingxu Chen
- Department of Psychiatry, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
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Cekuolis A, Schreiber-Dietrich D, Augustinienė R, Taut H, Squires J, Chaves EL, Dong Y, Dietrich CF. Incidental Findings in Pediatric Patients: How to Manage Liver Incidentaloma in Pediatric Patients. Cancers (Basel) 2023; 15:cancers15082360. [PMID: 37190288 DOI: 10.3390/cancers15082360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled "Incidental imaging findings-the role of ultrasound". IFs in the liver of newborns and children are rare and much less commonly encountered than in adults; as a result, they are relatively much more frequently malignant and life-threatening, even when they are of benign histology. Conventional B-mode ultrasound is the well-established first line imaging modality for the assessment of liver pathology in pediatric patients. US technological advances, resulting in image quality improvement, contrast-enhanced ultrasound (CEUS), liver elastography and quantification tools for steatosis have expanded the use of ultrasound technology in daily practice. The following overview is intended to illustrate incidentally detected liver pathology covering all pediatric ages. It aims to aid the examiner in establishing the final diagnosis. Management of incidentally detected focal liver lesions (FLL) needs to take into account the diagnostic accuracy of each imaging modality, the patient's safety issues (including ionizing radiation and nephrotoxic contrast agents), the delay in diagnosis, the psychological burden on the patient and the cost for the healthcare system. Moreover, this paper should help the pediatric clinician and ultrasound practitioner to decide which pathologies need no further investigation, which ones require interval imaging and which cases require further and immediate diagnostic procedures.
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Affiliation(s)
- Andrius Cekuolis
- Ultrasound Section, Department of Pediatric Radiology, Radiology and Nuclear Medicine Centre, Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania
| | | | - Rasa Augustinienė
- Ultrasound Section, Department of Pediatric Radiology, Radiology and Nuclear Medicine Centre, Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania
| | - Heike Taut
- Children's Hospital, Universitätsklinikum Dresden, Technische Universität Dresden, 01062 Dresden, Germany
| | - Judy Squires
- Department of Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Edda L Chaves
- Radiology Department, Hospital Regional Nicolas Solano, La Chorrera 1007, Panama
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permancence, 3013 Bern, Switzerland
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Möller K, Safai Zadeh E, Görg C, Dong Y, Cui XW, Faiss S, Dietrich CF. Prevalence of benign focal liver lesions and non-hepatocellular carcinoma malignant lesions in liver cirrhosis. ZEITSCHRIFT FÜR GASTROENTEROLOGIE 2022; 61:526-535. [PMID: 36413993 DOI: 10.1055/a-1890-5818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractLiver cirrhosis is associated with an increased risk of developing hepatocellular carcinoma (HCC). However, other benign and malignant liver lesions may co-exist or may be the only focal liver lesion (FLL) detected. Compared to HCC, comparatively little is known about the frequency and natural history of benign FLL in patients with established liver cirrhosis.This review analyses the prevalence and frequency of benign and malignant FLL others than hepatocellular carcinoma (HCC) in liver cirrhosis including imaging and autopsy studies. Understanding these data should be helpful in avoiding misdiagnoses.
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Affiliation(s)
| | - Ehsan Safai Zadeh
- Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, Philipps University Marburg, Marburg, Germany
| | - Christian Görg
- Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, Philipps University Marburg, Marburg, Germany
| | - Yi Dong
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Christoph F. Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Bozic D, Podrug K, Mikolasevic I, Grgurevic I. Ultrasound Methods for the Assessment of Liver Steatosis: A Critical Appraisal. Diagnostics (Basel) 2022; 12:2287. [PMID: 36291976 PMCID: PMC9600709 DOI: 10.3390/diagnostics12102287] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 08/10/2023] Open
Abstract
The prevalence of the non-alcoholic fatty liver disease has reached major proportions, being estimated to affect one-quarter of the global population. The reference techniques, which include liver biopsy and the magnetic resonance imaging proton density fat fraction, have objective practical and financial limitations to their routine use in the detection and quantification of liver steatosis. Therefore, there has been a rising necessity for the development of new inexpensive, widely applicable and reliable non-invasive diagnostic tools. The controlled attenuation parameter has been considered the point-of-care technique for the assessment of liver steatosis for a long period of time. Recently, many ultrasound (US) system manufacturers have developed proprietary software solutions for the quantification of liver steatosis. Some of these methods have already been extensively tested with very good performance results reported, while others are still under evaluation. This manuscript reviews the currently available US-based methods for diagnosing and grading liver steatosis, including their classification and performance results, with an appraisal of the importance of this armamentarium in daily clinical practice.
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Affiliation(s)
- Dorotea Bozic
- Department of Gastroenterology and Hepatology, University Hospital Center Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Kristian Podrug
- Department of Gastroenterology and Hepatology, University Hospital Center Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Ivana Mikolasevic
- Department of Gastroenterology and Hepatology, University Hospital Center Rijeka, Krešimirova 42, 51 000 Rijeka, Croatia
| | - Ivica Grgurevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 2, 10 000 Zagreb, Croatia
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