Abstract
Article: A Case-Control Study to Compare the Likelihood of Detecting Liver Disorders Using Coincident Measures of Doppler-Derived Portal Vein Pressure Gradients, Hepatic Venous Waveforms, and the Echogenicity of Liver Parenchyma
Authors: Joy D. Guthrie, PhD, RDMS, RDCS, RVT
Muhammad Y. Sheikh, MD, FACP, FACG, AGAF
Shana Morrell, PhD, MPH
Diane Neal, PhD
Category: Abdomen
Credit: 1 SDMS CME Credit
Objectives: After studying the article titled “A Case-Control Study to Compare the Likelihood of Detecting Liver Disorders Using Coincident Measures of Doppler-Derived Portal Vein Pressure Gradients, Hepatic Venous Waveforms, and the Echogenicity of Liver Parenchyma,” you will be able to:
Describe multiple sonographic techniques for predicting the likelihood of hepatocellular damage
Discuss the relative merits of echogenicity, hepatic venous flow waveforms, and portal vein pressure gradients as predictors of hepatocellular damage
Discuss the limitations of using parenchymal echogenicity to predict liver disorders
Normal pressure in the portal vein is typically
0–2 mm Hg 2–4 mm Hg 5–10 mm Hg 10–15 mm Hg
Portal hypertension is normally defined as a pressure difference between the portal vein and hepatic veins of
20 mm Hg 10 mm Hg 5 mm Hg 2 mm Hg
Techniques commonly used to detect liver fibrosis prior to the onset of complications include all of the following except
Liver biopsy Serum biomarkers Sonographic tissue measures Doppler-derived measures of portal vein flow
As biomarkers for liver hepatocyte damage, serum ALT and AST are considered to have
Good sensitivity and good specificity Good sensitivity and poor specificity Poor sensitivity and good specificity Poor sensitivity and poor specificity
Serum AST levels have been reported to be elevated in patients with
Liver disorders Congestive heart failure Morbid obesity All of the above
The threshold portal vein diameter considered diagnostic of portal hypertension is typically reported to be
10–13 mm 15–20 mm 8–10 mm 12–15 mm
Reported complications of liver biopsy include
Pain Bleeding Death All of the above
The efficacy of the 4-point ECHO grade scale in predicting hepatic fibrosis has declined over the past 20 years primarily because of
Improved sonographic imaging techniques Use of wide-bandwidth transducers for imaging Increasing population obesity Inherent spectral broadening of curvilinear transducers
Adipose tissue in overweight patients affects sonographic elastography in the detection of hepatic fibrosis by
Increasing tissue stiffness and thus increasing sensitivity Increasing tissue stiffness and thus decreasing sensitivity Decreasing tissue stiffness and thus increasing sensitivity Decreasing tissue stiffness and thus decreasing sensitivity
In the study reported, the most sensitive predictor of liver damage was the
Body mass index Echogenicity Hepatic venous flow waveform Portal vein pressure gradient
Footnotes