Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites

Anna Kohlhaas1, Esteban Durango1, Gunda Millonig1, Cecile Bastard2, Laurent Sandrin2, Mohammad Golriz3, Arianeb Mehrabi3, Markus W B&uuml;chler3, Helmut Karl Seitz1, Sebastian Mueller11Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Salem Medical Center,...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mueller S, Seitz HK, B&uuml;chler MW, Mehrabi A, Golriz M, Sandrin L, Bastard C, Millonig G, Durango E, Kohlhaas A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/b99d3929359949ada56f78d870d06566
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b99d3929359949ada56f78d870d06566
record_format	dspace
spelling	oai:doaj.org-article:b99d3929359949ada56f78d870d065662021-12-02T03:18:37ZTransient elastography with the XL probe rapidly identifies patients with nonhepatic ascites1179-1535https://doaj.org/article/b99d3929359949ada56f78d870d065662012-05-01T00:00:00Zhttp://www.dovepress.com/transient-elastography-with-the-xl-probe-rapidly-identifies-patients-w-a9791https://doaj.org/toc/1179-1535Anna Kohlhaas1, Esteban Durango1, Gunda Millonig1, Cecile Bastard2, Laurent Sandrin2, Mohammad Golriz3, Arianeb Mehrabi3, Markus W B&uuml;chler3, Helmut Karl Seitz1, Sebastian Mueller11Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Salem Medical Center, University of Heidelberg, Heidelberg, Germany; 2Department of Research and Development, Echosens, Paris, France; 3Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyBackground: In contrast with other elastographic techniques, ascites is considered an exclusion criterion for assessment of fibrosis stage by transient elastography. However, a normal liver stiffness could rule out hepatic causes of ascites at an early stage. The aim of the present study was to determine whether liver stiffness can be generally determined by transient elastography through an ascites layer, to determine whether the ascites-mediated increase in intra-abdominal pressure affects liver stiffness, and to provide initial data from a pilot cohort of patients with various causes of ascites.Methods and results: Using the XL probe in an artificial ascites model, we demonstrated (copolymer phantoms surrounded by water) that a transient elastography-generated shear wave allows accurate determination of phantom stiffness up to a water lamella of 20 mm. We next showed in an animal ascites model that increased intra-abdominal pressure does not affect liver stiffness. Liver stiffness was then determined in 24 consecutive patients with ascites due to hepatic (n = 18) or nonhepatic (n = 6) causes. The cause of ascites was eventually clarified using routine clinical, imaging, laboratory, and other tools. Valid (75%) or acceptable (25%) liver stiffness data could be obtained in 23 patients (95.8%) with ascites up to an ascites lamella of 39 mm. The six patients (25%) with nonhepatic causes of ascites (eg, pancreatitis, peritoneal carcinomatosis) had a significantly lower liver stiffness (&lt;8 kPa) as compared with the remaining patients with hepatic ascites (&gt;30 kPa). Mean liver stiffness was 5.4 kPa &plusmn; 1.3 versus 66.2 &plusmn; 13.3 kPa.Conclusion: In conclusion, the presence of ascites and increased intra-abdominal pressure does not alter underlying liver stiffness as determined by transient elastography. We suggest that, using the XL probe, transient elastography can be used first-line to identify patients with nonhepatic ascites at an early stage.Keywords: ascites, liver stiffness, transient elastography, liver cirrhosis, noncirrhotic ascites, congestion, peritoneal carcinomatosis, intra-abdominal pressure, alcoholic liver diseaseMueller SSeitz HKB&uuml;chler MWMehrabi AGolriz MSandrin LBastard CMillonig GDurango EKohlhaas ADove Medical PressarticleDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol 2012, Iss default, Pp 11-18 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Mueller S Seitz HK B&uuml;chler MW Mehrabi A Golriz M Sandrin L Bastard C Millonig G Durango E Kohlhaas A Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
description	Anna Kohlhaas1, Esteban Durango1, Gunda Millonig1, Cecile Bastard2, Laurent Sandrin2, Mohammad Golriz3, Arianeb Mehrabi3, Markus W B&uuml;chler3, Helmut Karl Seitz1, Sebastian Mueller11Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Salem Medical Center, University of Heidelberg, Heidelberg, Germany; 2Department of Research and Development, Echosens, Paris, France; 3Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyBackground: In contrast with other elastographic techniques, ascites is considered an exclusion criterion for assessment of fibrosis stage by transient elastography. However, a normal liver stiffness could rule out hepatic causes of ascites at an early stage. The aim of the present study was to determine whether liver stiffness can be generally determined by transient elastography through an ascites layer, to determine whether the ascites-mediated increase in intra-abdominal pressure affects liver stiffness, and to provide initial data from a pilot cohort of patients with various causes of ascites.Methods and results: Using the XL probe in an artificial ascites model, we demonstrated (copolymer phantoms surrounded by water) that a transient elastography-generated shear wave allows accurate determination of phantom stiffness up to a water lamella of 20 mm. We next showed in an animal ascites model that increased intra-abdominal pressure does not affect liver stiffness. Liver stiffness was then determined in 24 consecutive patients with ascites due to hepatic (n = 18) or nonhepatic (n = 6) causes. The cause of ascites was eventually clarified using routine clinical, imaging, laboratory, and other tools. Valid (75%) or acceptable (25%) liver stiffness data could be obtained in 23 patients (95.8%) with ascites up to an ascites lamella of 39 mm. The six patients (25%) with nonhepatic causes of ascites (eg, pancreatitis, peritoneal carcinomatosis) had a significantly lower liver stiffness (&lt;8 kPa) as compared with the remaining patients with hepatic ascites (&gt;30 kPa). Mean liver stiffness was 5.4 kPa &plusmn; 1.3 versus 66.2 &plusmn; 13.3 kPa.Conclusion: In conclusion, the presence of ascites and increased intra-abdominal pressure does not alter underlying liver stiffness as determined by transient elastography. We suggest that, using the XL probe, transient elastography can be used first-line to identify patients with nonhepatic ascites at an early stage.Keywords: ascites, liver stiffness, transient elastography, liver cirrhosis, noncirrhotic ascites, congestion, peritoneal carcinomatosis, intra-abdominal pressure, alcoholic liver disease
format	article
author	Mueller S Seitz HK B&uuml;chler MW Mehrabi A Golriz M Sandrin L Bastard C Millonig G Durango E Kohlhaas A
author_facet	Mueller S Seitz HK B&uuml;chler MW Mehrabi A Golriz M Sandrin L Bastard C Millonig G Durango E Kohlhaas A
author_sort	Mueller S
title	Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
title_short	Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
title_full	Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
title_fullStr	Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
title_full_unstemmed	Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites
title_sort	transient elastography with the xl probe rapidly identifies patients with nonhepatic ascites
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/b99d3929359949ada56f78d870d06566
work_keys_str_mv	AT muellers transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT seitzhk transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT bampuumlchlermw transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT mehrabia transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT golrizm transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT sandrinl transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT bastardc transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT millonigg transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT durangoe transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites AT kohlhaasa transientelastographywiththexlproberapidlyidentifiespatientswithnonhepaticascites
_version_	1718401816188682240

Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites

Ejemplares similares