Abstract
Article: The Prediction of Liver Disease Status Using a Combination of Sonographic and Doppler-Derived Observations of the Portal Venous System
Author: Joy Guthrie, PhD, RDMS, RDCS, RVT, RCS, RVS, FSDMS
Category: Abdomen
Credit: 1.0 SDMS CME Credit
Objectives: After studying the article titled “The Prediction of Liver Disease Status Using a Combination of Sonographic and Doppler-Derived Observations of the Portal Venous System,” you will be able to:
Describe sonographic data important for categorizing liver disease status
Describe the advantages and potential limitations of sonography to characterize liver disease
Compare current sonographic techniques for evaluating liver disease with the traditional ECHO grade scale
The gold standard for the diagnosis of liver disease status is
Sonography Angiography Magnetic resonance imaging Biopsy
When using the ECHO grade scale to evaluate the liver parenchyma, a score of “0” corresponds to Vessels and diaphragm not seen Vessels seen but diaphragm not seen Grainy liver but vessels and diaphragm seen Normal liver
Sensitivity of the ECHO grading scale is significantly affected by Associated gallbladder disease Patient obesity Pancreatic inflammation Inflammatory bowel conditions
Duplex sonography of a fat-infiltrated liver may mimic fibrosis in that Hepatic artery flow signals appear more high resistance Portal venous flow signals are diminished The liver appears more echogenic Hepatic venous flow signals lose phasicity
The reported fatal complication rate for liver biopsy is approximately Less than 1% 1% 2% 5%
A common cause of false-positive interpretation of changes in hepatic venous flow waveforms when evaluating for liver disease is Normal respiratory variations Poor Doppler angle Portal venous flow interference Enlargement of the inferior vena cava
Threshold portal vein diameter, which indicates portal hypertension, is reported to be 8–10 mm 10–13 mm 15–18 mm 20–22 mm
Threshold portal venous pressure, which may indicate portal hypertension, is suggested to be 10–13 mm Hg 15–18 mm Hg 20–23 mm Hg 25–28 mm Hg
In the definition of the PREW score, the “E” is used to designate Elasticity of the liver parenchyma Echogenicity of the liver parenchyma Extrahepatic fatty tissue Degree of hepatic encephalopathy
The highest PREW scores were consistently seen in patients with Gallbladder disease Hepatitis Cirrhosis/ascites Nonalcoholic fatty liver disease
Footnotes