Liver involvement in a large cohort of patients with hereditary hemorrhagic telangiectasia: echo-color-Doppler vs multislice computed tomography study
| Autor: | G Pasculli, Carlo Sabbà, Arnaldo Scardapane, M. Memeo, Patrizia Suppressa, Paolo Buonamico, Gennaro M. Lenato, Francesco Domenico D'Ovidio |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Hepatic Veins Angioma Arteriovenous Malformations Cohort Studies Hepatic Artery Medicine Humans Multislice Ultrasonography Doppler Color Vein Telangiectasia Aged Hepatology business.industry Vascular disease Ultrasound Middle Aged medicine.disease medicine.anatomical_structure Female Telangiectasia Hereditary Hemorrhagic Radiology Tomography medicine.symptom business Tomography X-Ray Computed Artery |
| Zdroj: | Journal of hepatology. 48(5) |
| ISSN: | 0168-8278 |
| Popis: | Background/Aims Hepatic arterio-venous malformations (HAVMs) have been found in 74% of hereditary hemorrhagic telangiectasia (HHT) patients with multislice CT (MSCT). This single-blind study aimed to compare the diagnostic accuracy of echo-color-Doppler with MSCT and identify the most sensitive ultrasound criteria indicating hepatic shunts. Methods One hundred and fifty-three HHT patients were systematically screened for HAVMs by biological tests, abdominal MSCT and echo-color-Doppler. Twenty-five normal subjects and 15 cirrhotic patients were also included as control groups. Both intrahepatic ("color spots" and hypervascularization) and extrahepatic parameters (diameter, flow velocity and tortuosity of hepatic artery and diameter and flow velocity of portal/hepatic vein) were utilized. "Color-spots" are defined as subcapsular vascular spots with a high-velocity arterial blood flow and low resistivity index and can identify extremely small HAVMs. Results CT was positive in 128/153 (84%) patients and Doppler color spots were found in 131/153 (86%) patients. The sensitivity, specificity and diagnostic accuracy of "color spots" compared to MSCT were 95.3%, 68.0% and 91.8%, respectively. The "color-spot" showed a greater correlation to CT ( V index =0.655; p V =0.317). In 20/29 (69%) subjects, echo-color-Doppler, confirmed by CT, identified the third criterion for definite HHT diagnosis. Conclusions Intrahepatic criteria was superior to extrahepatic criteria for identification of HAVMs. A new Doppler parameter ("color-spots") with an optimal accuracy for detecting HAVMs is proposed for easy periodic screening of HHT patients. |
| Databáze: | OpenAIRE |
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