Standardization and Challenges in Ultrasound-Based Diagnosis of Steatotic Liver Disease

7005 Evaluation of a minilaparoscopical technique in the diagnosis of liver diseases.

Peritoneoscopy: its value in the diagnosis of liver disease

Intelligent liver function testing (iLFT): A trial of automated diagnosis and staging of liver disease in primary care

Purpose of the study. To assess the sensitivity, specificity and diagnostic accuracy of the method for non-invasive differential diagnosis of liver diseases by polyhepatography.Materials and methods. A random sampling method examined 45 primary patients. Polygepatography was performed on all patients to detect disorders of intrahepatic microcirculation during primary contacting. Based on the detected changes in intrahepatic hemodynamics and based on the morphofunctional hemodynamic model, a conclusion was made about the violation of intrahepatic blood flow and an assumption was made about the etiology and stage of liver disease. Subsequently, the diagnosis of liver diseases was verified after a detailed study of clinical-laboratory, instrumental and morphological data generally accepted in hepatology. Puncture liver biopsy by the Mancini method was performed in 11.1 % of the subjects.Results. All subjects were divided into three groups based on the data obtained on impaired intrahepatic hemodynamics during polyhepatography (PHG). The group I consisted of patients with impaired venous inflow, the group II included patients with impaired arteriovenous inflow, and group III — with impaired venous outflow. The obtained polyhepatographic data were compared with the results of clinical-laboratory, instrumental and morphological data. The high sensitivity, sufficient specificity and accuracy of the polyhepatography method in the diagnosis of chronic liver diseases have been determined.Conclusion. The studies carried out indicate that PHG is a simple, accessible and not burdensome examination method for the patient, which makes it possible to assess the localization of intrahepatic blood flow disorders, and, with a certain degree of probability, to assume the etiological factor of the disease and the stage of the disease. Given the specificity of changes in liver hemodynamics, de pending on the etiological factor and stage of the disease, assessment of intrahepatic hemodynamics by polyhepatography can be recommended as a screening method for examining patients with liver diseases, which will shorten the diagnostic search time.

Liver transplantation for alcoholic hepatitis in the United States: Excellent outcomes with profound temporal and geographic variation in frequency.

Intelligent Liver Function Testing (iLFT): A Trial of Reflex Testing, Automated Diagnosis and Staging of Liver Disease

1253: Diagnosis of liver diseases using contrast ultrasound utilizing phagocytosis of microbubbles by Kupffer cells

To determine the feasibility of the use of Medicaid data to study drug-induced acute liver disease, we reviewed the medical records of 414 patients receiving Medicaid, age 20 or older, with an ICD-9-CM inpatient billing code consistent with acute hepatitis. Of the patients whose records were reviewed, 15.9% were alcoholics, 31.9% had acute hepatitis A or B, 13.5% were intravenous drug users, 8.2% had acute cholecystitis or choledocholithiasis, and 4.1% had received a blood transfusion within the previous 6 months. No diagnosis of liver disease was found in 10.6% of the patients, and 5.7% had chronic liver disease. Of the 169 patients with idiopathic acute liver disease identified, many had very mild liver disease and were hospitalized for reasons other than liver disease. We conclude that Medicaid billing data has high reliability and validity for the diagnosis of acute liver disease. However, primary medical records are essential for the study of drug-induced hepatitis, to be able to exclude other causes of liver disease, and to obtain information not included in the computer data.

Introduction Early detection and individualized treatment of patients with liver disease is the key to survival. Radiomics can extract high-throughput quantitative features by multimode imaging, which has good application prospects for the diagnosis, staging and prognosis of benign and malignant liver diseases. Therefore, this paper summarizes the current research status in the field of liver disease, in order to help these patients achieve personalized and precision medical care. Areas covered This paper uses several keywords on the PubMed database to search the references, and reviews the workflow of traditional radiomics, as well as the characteristics and influencing factors of different imaging modes. At the same time, the references on the application of imaging in different benign and malignant liver diseases were also summarized. Expert opinion For patients with liver disease, the traditional imaging evaluation can only provide limited information. Radiomics exploits the characteristics of high-throughput and high-dimensional extraction, enabling liver imaging capabilities far beyond the scope of traditional visual image analysis. Recent studies have demonstrated the prospect of this technology in personalized diagnosis and treatment decision in various fields of the liver. However, further clinical validation is needed in its application and practice.

Prediction of chronic liver disease patients using integrated projection based statistical feature extraction with machine learning algorithms

Liver disease is an early complication in children with cystic fibrosis (CF).The clinical manifestations in hepatobiliary disease of CF include neonatal cholestasis, liver steatosis, liver fibrosis, biliary lithiasis, focal biliary cirrhosis and multilobular cirrhosis, with or without portal hypertension. Changes in the tests evaluating the liver function are inconsistent and are not correlated with the severity of the liver lesions. The diagnosis of liver disease in CF requires the presence of at least two of the following four diagnosis criteria: clinical manifestations, pathologic liver function tests, ultrasound and histologic changes. The annual follow-up to evaluate the liver function is s recommended for diagnosis of asymptomatic liver disease and early initiation of treatment with ursodeoxycholic acid. The improvement of the liver function influences life quality and increases the survival rate in patients with CF.

Non-alcoholic fatty liver disease is prevalent in obese patients. Liver biopsy remains the best diagnostic tool for confirmation. We evaluated the effectiveness of macroscopic parameters of laparoscopy in diagnosis of liver diseases. Moreover, correlations of laparoscopy with histology and laboratory data were also studied. From December 2004 to April 2006, 126 morbidly obese patients submitted to laparoscopic bariatric surgery at the En-Chu-Kong Hospital were prospectively studied. There were correlations of histologic steatosis with liver surface fat spot density, liver margin shape, and liver size. Histologic inflammation was related to liver color, vascularity beneath hepatic capsule, liver margin shape, liver size, and liver surface nodularity. Histologic fibrosis had relations to liver color, liver surface nodularity, liver size, varices of ligamentum teres. Spleen size was related to liver surface nodularity and spleen congestion. Relationships of laboratory data with laparoscopic findings included: aspartate transaminase (AST) level with liver size, alanine transaminase (ALT) level with liver color and liver size, albumin level with liver margin shape and liver surface fibrosis and liver size, total protein level with liver size, alkaline phosphatase (ALP) level with liver surface fibrosis, blood glucose level with liver surface nodularity and spleen size, C-peptide with liver size. Besides, there were relations of gamma-GT level with liver color, liver margin shape, liver and spleen size. Besides histology and laboratory studies, laparoscopic inspection of the abdominal cavity provides important and additional information, which contributed to the final diagnosis of chronic liver diseases and detection of possible pathology in patients.

Liver disease is a primary cause of liver-related morbidity and mortality worldwide. Currently, histological examination is the gold standard for diagnosis and classification of liver disease; however, due to its several drawbacks, including the risk of complications and sampling variability, noninvasive diagnostic options are favorable. Exosomal miRNAs have recently been considered as an important source of medical biomarkers due to being widely distributed in body fluids. This review summarizes existing concepts related to the origin, mode of transportation and possible functions of exosomal miRNAs, and recent findings on the role of exosomal miRNAs in liver diseases and development of exosomal miRNA-based diagnostic biomarkers in the primary forms of liver diseases.

Objective To evaluate the value of liver biopsy on diagnosis and treatment of liver diseases. Methods The clinical data of 102 patients who received B ultrasound guided 1 seconds（1s） of liver biopsy in the diagnosis and treatment were retrospectively analyzed. Results The clinical and pathological diagnosis coincidence rate was 78. 43%（80 / 102）,92. 00% for chronic active hepatitis, 78. 94% for subacute severe hepatitis,73. 37% for chronic severe hepatitis,66. 67% for acute icteric hepatitis,66. 67% for cirrhosis,55. 56% for chronic persistent hepatitis. Conclusions Liver biopsy is an important method to diagnose the cause of abnormal liver function,it has an important value to deter-mine the diagnosis and establish the most appropriate treatment. Key words: Biopsy; Liver disease; Diagnosis; Treatment

Laparoscopy combined with guided liver biopsy offers many advantages in the diagnosis and staging of chronic liver diseases and is superior to other diagnostic procedures. We developed a new minilaparoscopic technique and evaluated the utility of this minimally invasive laparoscopic system in the first 320 patients who underwent diagnostic assessment for liver disease or peritoneal carcinosis. Between July 1996 and February 1998, minilaparoscopy, with analgesia and sedation was carried out in 320 patients. It was done using a 1.9-mm optical instrument, which was inserted through the same 2.75-mm trocar as the Veress needle used for inflating the pneumoperitoneum. Thus only a single puncture of the peritoneum was required. Liver biopsies, when indicated, were obtained under laparoscopic control with the Silverman needle through a short 2-mm additional trocar when the Menghini technique was used. Complication rates, patient discomfort and duration of procedure were extremely low with minilaparoscopy. We observed no serious complications, two complications that could be treated conservatively and technical difficulties in eight of 320 patients, which prevented liver biopsy in 2.8%. These minor difficulties all happened during the first 40 procedures, whereas after the initial 40 examinations of each investigator no further difficulties arose. This new minilaparoscopic technique allows a macroscopic and histological diagnosis of liver disease with minimal invasiveness, easy handling, excellent patient tolerance, and also a high degree of safety in patients with coagulation defects. Exploratory laparoscopy is an accurate and safe method for intra-abdominal diagnosis of liver diseases and peritoneal carcinosis.