Literature DB >> 22022639

Value of acoustic radiation force impulse elastography for the assessment of ascites syndrome.

Simona Bota1, Ioan Sporea, Roxana Sirli, Alina Popescu, Mirela Dănilă, Mădălina Sendroiu.   

Abstract

AIM: To assess the feasibility of performing acoustic radiation force impulse (ARFI) elastography in patients with ascites and its predictive value for the cirrhotic or non-cirrhotic etiology of ascites.
METHODS: Our study included 153 patients with ascites, mean age 58.8 ± 13.1 years. One hundred and fifteen (75.2%) patients had ascites in the context of cirrhosis, 29 (18.9%) had non-cirrhotic ascites (diagnosed by clinical, ultrasound, endoscopic and/or laparoscopic criteria) and in 9 (5.9%) cases we could not establish the etiology of ascites. We performed 10 ARFI measurements and the median value was calculated and expressed in meters/second (m/s). Among the 29 patients with non-cirrhotic ascites were included: 20 laparoscopically demonstrated peritoneal carcinomatosis with histological confirmation, 7 acute pancreatitis with ascites which later resolved, and one case each of lymphatic ascites and ascites in the context of a liver abscess. In 11 of the 20 patients with peritoneal carcinomatosis, the liver structure was homogenous in the ultrasound examination and in 9 patients the ultrasound exam revealed liver metastases.
RESULTS: We could not obtain valid ARFI measurements in 5 patients (3.2%). The mean liver stiffness measurements by means of ARFI were statistically significantly higher in patients with cirrhotic ascites than in those with non-cirrhotic ascites: 3.04 ± 0.70 vs 1.45 ± 0.59 m/s (P < 0.001). For a cut-off value of 1.8 m/s for predicting cirrhosis (and ascites in the context of cirrhosis), as obtained in a previous study, ARFI had 98.1% sensitivity, 86.2% specificity, 96.4% positive predictive value, 92.5% negative predictive value and 95.6% accuracy for predicting cirrhotic ascites. For a cut-off value of 1.9 m/s the accuracy was 94.9% and for a 2 m/s cut-off value it was 92.8%.
CONCLUSION: ARFI elastography is feasible in most patients with ascites and has a very good predictive value for the cirrhotic or non-cirrhotic etiology of ascites.

Entities:  

Keywords:  Acoustic radiation force impulse; Ascites; Elastography; Liver cirrhosis; Liver stiffness

Year:  2011        PMID: 22022639      PMCID: PMC3198265          DOI: 10.4329/wjr.v3.i8.205

Source DB:  PubMed          Journal:  World J Radiol        ISSN: 1949-8470


  19 in total

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2.  Noninvasive acoustic radiation force impulse (ARFI) elastography for assessing the severity of fibrosis in the post-operative patients with biliary atresia.

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  5 in total

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