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2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(3): 449-457, 2024 Jun.
Article in Chinese | MEDLINE | ID: mdl-38953270

ABSTRACT

Long-term treatment of anemia involving frequent blood transfusions and intravenous iron administration increases the risks of hepatic iron overload and steatosis in the patients undergoing hemodialysis.Pathological accumulation of iron damages hepatocytes,not only elevating the risks of progressive hepatic fibrosis and cirrhosis but also potentially accelerating the process of hepatic steatosis.Iron overload and steatosis may interact with each other,exacerbating liver damage and ultimately leading to further deterioration of hepatic fibrosis and cirrhosis.MRI characterized by non-invasiveness and high repeatability,enables the simultaneous quantitative assessment of hepatic iron and fat content,providing crucial information for early diagnosis and intervention of liver diseases.In recent years,researchers have achieved significant advances in the application of MRI in the diagnosis and treatment of liver diseases.MRI can accurately reflect the extent of hepatic iron overload and steatosis in patients and predict the risk of liver diseases.This article reviews the latest advances,challenges,and perspectives in the application of MRI in assessing hepatic iron overload and steatosis in the patients undergoing hemodialysis,aiming to offer valuable references for clinical practice.


Subject(s)
Fatty Liver , Iron Overload , Magnetic Resonance Imaging , Renal Dialysis , Humans , Iron Overload/diagnostic imaging , Magnetic Resonance Imaging/methods , Fatty Liver/diagnostic imaging , Fatty Liver/metabolism , Liver/diagnostic imaging , Liver/metabolism , Liver/pathology
3.
World J Gastroenterol ; 30(22): 2920-2922, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38947285

ABSTRACT

Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases. In some countries, its use is restricted to radiologists, limiting access for other clinicians, such as gastroenterologists. Endoscopic ultrasound, as a novel technique, plays a crucial role in diagnosis and treatment of digestive diseases. However, its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists, leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.


Subject(s)
Endosonography , Liver Diseases , Humans , Endosonography/methods , Liver Diseases/diagnostic imaging , Liver Diseases/therapy , Liver/diagnostic imaging , Liver/pathology , Ultrasonography, Interventional/methods
4.
Can J Gastroenterol Hepatol ; 2024: 6623848, 2024.
Article in English | MEDLINE | ID: mdl-38947874

ABSTRACT

Purpose: To use hepatic uptake index (HUI) of liver lobes on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) to discriminate between patients with hepatitis B-related cirrhosis in compensated and decompensated statuses. Methods: Forty-four consecutive patients with hepatitis B-related cirrhosis who underwent Gd-EOB-DTPA-enhanced MRI were divided into compensated and decompensated statuses based on clinical evaluation. Volume and signal intensity of individual lobes were retrospectively measured to calculate HUI of the right liver lobe (RHUI), medial (MHUI) and lateral (LHUI) left liver lobes, and caudate lobe (CHUI). Spearman's rank correlation analyses were performed to evaluate relationships of lobe-based HUI with Child-Pugh and model for end-stage liver disease (MELD) scoring system scores in compensated and decompensated statuses. The Mann-Whitney U-test was used to compare the lobe-based HUI between compensated and decompensated statuses. The performance of lobe-based HUI in distinguishing cirrhosis was evaluated using receiver operating characteristic (ROC) analysis, and the area under the ROC curve (AUC) was calculated as a measure of accuracy. Delong's method was used for statistical analysis to elucidate which HUI is optimal. Results: Compensated and decompensated liver cirrhosis were confirmed in 25 (56.82%) and 19 (43.18%) patients, respectively. According to Spearman's rank correlation analysis, RHUI, MHUI, LHUI, and CHUI were all significantly associated with Child-Pugh and MELD scores (all P values <0.05). Receiver operating characteristic analysis demonstrated that among all lobe-based HUI parameters, RHUI could best perform the previous discrimination with a cut-off of 485.73 and obtain an AUC of 0.867. The AUC of RHUI improved and was significantly different from that of MHUI, LHUI, and CHUI (P = 0.03, P = 0.007, and P < 0.001, respectively, Delong's test). Conclusions: The RHUI could help quantitatively discriminate hepatitis B-related cirrhosis between compensated and decompensated statuses.


Subject(s)
Contrast Media , Gadolinium DTPA , Liver Cirrhosis , Liver , Magnetic Resonance Imaging , Humans , Gadolinium DTPA/pharmacokinetics , Gadolinium DTPA/administration & dosage , Liver Cirrhosis/diagnostic imaging , Female , Male , Contrast Media/pharmacokinetics , Middle Aged , Magnetic Resonance Imaging/methods , Retrospective Studies , Liver/diagnostic imaging , Adult , ROC Curve , Aged , Severity of Illness Index , Hepatitis B/complications , Hepatitis B/diagnostic imaging
5.
Lipids Health Dis ; 23(1): 208, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38956572

ABSTRACT

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become an important health issue in adolescents. Although several parameters and indices have been investigated for the evaluation of NAFLD in adults, these indices are limited in adolescents. In this study, body mass index, waist circumference, triponderal mass index, HbA1c, homeostatic model assessment insulin resistance (HOMA-IR), triglyceride/high-density lipoprotein (Tg/HDL), the lipid accumulation product (LAP) index, the triglyceride-glucose (TyG) index and the aminotransferase (AT) index were examined together, and their diagnostic values in the clinical treatment of NAFLD were compared. MATERIALS AND METHODS: Seventynine adolescents (10-19 years old) with obesity who were admitted to a pediatric clinic between January and August 2022 and who were diagnosed with exogenous obesity without any comorbidities were included in the study. The presence of NAFLD was evaluated by liver magnetic resonance imaging. The laboratory findings were obtained retrospectively from system records. Parameters were compared between the NAFLD (+) and NAFLD (-) groups. Logistic regression analysis was used to determine the most effective factors for NAFLD treatment. Receiver operating characteristic (ROC) analysis was performed with significant indices. Sex, HOMA-IR, TyG and AT indices were evaluated together with multivariate analysis to design a diagnostic scale. RESULTS: HbA1c, HOMA-IR, AT indices and TyG indices were greater in the NAFLD (+) group (P = 0.012; P = 0.001; P = 0.012; P = 0.002, respectively). There was a positive correlation between liver fat percentage and HOMA-IR, the TyG index, the AT index, and Tg/HDL. According to the regression analysis, male sex and elevated HOMA-IR were determined to be significant risk factors for the presence of NAFLD. A probability scale with 4 parameters [sex, HOMA-IR, the TyG index, and alanine aminotransferase (ALT)] was designed with 82.5% specificity and 80% sensitivity. CONCLUSION: Evaluation of the HOMA-IR and TyG indices, especially in high-risk patients, will support the diagnosis of NAFLD via ultrasonography. A probability scale with ALT, HOMA-IR, TyG, and sex data with a diagnostic accuracy of 80% may aid in the diagnosis of NAFLD in adolescents with obesity.


Subject(s)
Body Mass Index , Insulin Resistance , Non-alcoholic Fatty Liver Disease , Triglycerides , Humans , Non-alcoholic Fatty Liver Disease/blood , Non-alcoholic Fatty Liver Disease/diagnosis , Adolescent , Male , Female , Triglycerides/blood , Child , Young Adult , Glycated Hemoglobin/metabolism , Glycated Hemoglobin/analysis , Obesity/blood , Obesity/complications , ROC Curve , Blood Glucose/metabolism , Waist Circumference , Lipoproteins, HDL/blood , Alanine Transaminase/blood , Liver/pathology , Liver/metabolism , Liver/diagnostic imaging , Retrospective Studies , Pediatric Obesity/blood , Pediatric Obesity/complications
6.
Zhonghua Gan Zang Bing Za Zhi ; 32(6): 572-576, 2024 Jun 20.
Article in Chinese | MEDLINE | ID: mdl-38964902

ABSTRACT

Liver biopsy is an important means of clinical diagnosis and treatment of liver diseases, but it is not easily accepted by patients because of its invasiveness. The most commonly employed liver biopsy approaches are percutaneous or transjugular. Endoscopic ultrasound-guided liver biopsy (EUS-LB), a newly emerging transjugular technique, has been widely studied and applied in recent years, but its application in China is less common. The EUS-LB has the advantages of high safety and comfort, simultaneous sampling of both liver lobes, and adequate sampling volume; however, it also has the disadvantages of high requirements for hardware, operators, and cost. This article reviews the clinical application of EUS-LB in accordance with pertinent research findings from recent years and discusses its advantages, disadvantages, and implementation feasibility.


Subject(s)
Endosonography , Liver , Humans , Liver/pathology , Liver/diagnostic imaging , Endosonography/methods , Liver Diseases/pathology , Liver Diseases/diagnostic imaging , Liver Diseases/diagnosis
7.
Zhonghua Gan Zang Bing Za Zhi ; 32(6): 545-550, 2024 Jun 20.
Article in Chinese | MEDLINE | ID: mdl-38964897

ABSTRACT

Objective: To explore the MRI characteristics of the hepatic epithelioid hemangioendothelioma (HEHE) classification according to morphology and size. Methods: The clinical, pathological, and MRI imaging data of 40 cases with HEHE confirmed pathologically from December 2009 to September 2021 were retrospectively analyzed. A paired sample t-test was used for comparison between the two groups. Results: There were 40 cases (5 solitary, 24 multifocal, 9 local fusion, and 2 diffuse fusion) and 214 lesions (163 nodules, 31 masses, and 20 fusion foci). The most common features of lesions were subcapsular growth and capsular depression. The signal intensity of lesions ≤1cm was usually uniform with whole or ring enhancement. Nodules and mass-like lesions ≥1cm on a T1-weighted image had slightly reduced signal intensity or manifested as a halo sign. Target signs on a T2-weighted image were characterized by: target or centripetal enhancement; fusion-type lesions; irregular growth and hepatic capsular retraction, with ring or target-like enhancement in the early stage of fusion and patchy irregular enhancement in the late stage; blood vessels traversing or accompanied by malformed blood vessels; focal bleeding; an increasing proportion of extrahepatic metastases and abnormal liver function with the type of classified manifestation; primarily portal vein branches traversing; and reduced overall intralesional bleeding rate (17%). Lollipop signs were presented in 19 cases, with a high expression rate in mass-type lesions (42%). The fusion lesions were expressed, but the morphological manifestation was atypical. The diffusion-weighted imaging mostly showed high signal or target-like high signal. An average apparent diffusion coefficient of lesions was (1.56±0.36) ×10(-3)mm(2)/s, which was statistically significantly different compared with that of adjacent normal liver parenchyma (t=8.28, P<0.001). Conclusion: The MRI manifestations for the HEHE classification are closely related to the morphology and size of the lesions and have certain differences and characteristics that are helpful for the diagnosis of the disease when combined with clinical and laboratory examinations.


Subject(s)
Hemangioendothelioma, Epithelioid , Liver Neoplasms , Magnetic Resonance Imaging , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/classification , Liver Neoplasms/pathology , Hemangioendothelioma, Epithelioid/diagnostic imaging , Hemangioendothelioma, Epithelioid/diagnosis , Hemangioendothelioma, Epithelioid/classification , Retrospective Studies , Magnetic Resonance Imaging/methods , Liver/pathology , Liver/diagnostic imaging , Female , Male , Middle Aged , Adult
8.
Medicine (Baltimore) ; 103(27): e38796, 2024 Jul 05.
Article in English | MEDLINE | ID: mdl-38968455

ABSTRACT

RATIONALE: Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade malignant soft tissue sarcoma that primarily affects the distal extremities in adults, with the highest incidence in patients in their 40s and 50s. It has a high local recurrence rate and a low metastasis rate. Although MIFSs have been documented in other sites, an MIFS in the liver is highly unusual. Herein, we present a case of a patient with hepatic MIFS. PATIENT CONCERNS: The patient was a 58-year-old Chinese man with abdominal pain as the primary symptom. Abdominal computed tomography and magnetic resonance imaging revealed a mass in the right posterior lobe of the liver. The patient underwent surgical excision, and the excised specimen was identified as MIFS. Three years later, the patient returned to our hospital for abdominal pain. Computed tomography and magnetic resonance imaging revealed a mass in liver segments 2/3/4. DIAGNOSIS: Postoperative pathological examination of the tumor revealed the recurrence of MIFS. INTERVENTIONS: The patient underwent surgical resection of the MIFS. OUTCOMES: The patient received multiple pirarubicin-based chemotherapy treatments and an ALK inhibitor (anlotinib) within 6 months after surgery, but the tumor recurred. LESSONS: MIFS can not only occur in the proximal limbs, trunk, head, and neck but can also affect the abdominal organs. Surgical resection remains the primary treatment option for MIFS in the absence of any contraindications. Because the recurrence rate of MIFS is high, meticulous long-term monitoring is required.


Subject(s)
Fibrosarcoma , Liver Neoplasms , Humans , Middle Aged , Male , Liver Neoplasms/surgery , Liver Neoplasms/pathology , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/diagnosis , Fibrosarcoma/surgery , Fibrosarcoma/diagnosis , Fibrosarcoma/pathology , Tomography, X-Ray Computed , Neoplasm Recurrence, Local/surgery , Magnetic Resonance Imaging , Liver/pathology , Liver/diagnostic imaging
9.
Medicine (Baltimore) ; 103(27): e38817, 2024 Jul 05.
Article in English | MEDLINE | ID: mdl-38968493

ABSTRACT

A cross-sectional study to explore the correlation between cardiac and hepatic iron overload and its impact on the quality of life in children diagnosed with severe beta-thalassemia major (ß-TM). A cohort of 55 pediatric patients with ß-TM, diagnosed via genetic testing at the Affiliated Hospital of Guangdong Medical University from January 2015 to January 2022, was included in this study. The assessment of cardiac and hepatic iron overload was conducted using the magnetic resonance imaging T2* technique. The Chinese version of the Pediatric Quality of Life Inventory (PedsQL) 4.0. Pearson correlation analysis was utilized to assess the relationships between the cardiac and hepatic T2* values and between these T2* values and the total scores of PedsQL 4.0. Analysis showed no significant correlation between cardiac and hepatic T2* values. However, a significant relationship was observed between cardiac T2* values and PedsQL 4.0 total scores (r = 0.313, P < .05), indicating that cardiac, but not hepatic, iron overload is associated with the quality of life. This study highlights the absence of correlation between cardiac and hepatic iron overload levels and demonstrates a significant impact of cardiac iron overload on the quality of life in children with ß-TM. These findings suggest the need for a focused approach to cardiac health in managing ß-TM.


Subject(s)
Iron Overload , Liver , Magnetic Resonance Imaging , Quality of Life , beta-Thalassemia , Humans , beta-Thalassemia/psychology , beta-Thalassemia/complications , Cross-Sectional Studies , Iron Overload/diagnostic imaging , Male , Female , Child , Magnetic Resonance Imaging/methods , Liver/diagnostic imaging , Liver/metabolism , Child, Preschool , Adolescent , Myocardium/metabolism
10.
J Intern Med ; 296(2): 177-186, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38959258

ABSTRACT

BACKGROUND: Cleavage products from collagen formation and degradation hold potential as first-line biomarkers for the risk of advanced fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we evaluated the performance of PRO-C3, PRO-C6, C4M, PRO-C18L, and the clinical score ADAPT (age, diabetes, PRO-C3, and platelet count) to detect patients with an LSM >8 kPa or >12 kPa in comparison to the Fibrosis-4 Index (FIB-4). METHODS: Serum from patients with MASLD (n = 269) from six Swedish University Hospitals was analyzed using enzyme-linked immunosorbent assay-based methods. Liver stiffness measurement (LSM) by vibration-controlled transient elastography was performed. The area under the curve (AUC), calibration curves, and net benefit analysis were used. RESULTS: An LSM >8 kPa was found in 108 (40.1%) patients. PRO-C3, PRO-C6, C4M, and PRO-C18L had AUCs ranging from 0.48 to 0.62. ADAPT had the highest AUC (0.73, 95% confidence interval [CI] = 0.67-0.79) to detect patients >8 kPa, compared to FIB-4 (0.71, (95%CI = 0.64-0.77, p = 0.35), and had a higher net benefit compared to FIB-4 from a probability threshold of 15%. FIB-4 and ADAPT performed equally well to detect patients with an LSM >12 kPa, AUC 0.76 versus 0.76, p = 0.93. CONCLUSIONS: ADAPT seems to be marginally better than FIB-4 in identifying patients with an LSM >8 kPa. However, the clinical utility of ADAPT as a first line test is uncertain, especially in low-risk populations. The overall performance of FIB-4 was similar to that of ADAPT in detecting patients with an LSM of >12 kPa. Altogether, the results suggest that ADAPT might be useful to detect earlier stages of fibrosis in MASLD, but that FIB-4 remains a first-line test for advanced fibrosis.


Subject(s)
Biomarkers , Collagen , Elasticity Imaging Techniques , Humans , Biomarkers/blood , Male , Female , Middle Aged , Collagen/metabolism , Fatty Liver/diagnosis , Fatty Liver/diagnostic imaging , Fatty Liver/complications , Liver Cirrhosis/complications , Liver Cirrhosis/blood , Liver Cirrhosis/diagnosis , Aged , Liver/diagnostic imaging , Liver/pathology , Adult
12.
BMC Gastroenterol ; 24(1): 229, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39044153

ABSTRACT

BACKGROUND: To identify factors associated with non-alcoholic fatty liver disease over a 5-year period. METHODS: Three hundred seven participants, including 165 women, with a mean age of 55.6 ± 12.0 years underwent continuous quantitative MRI of the liver using the proton-density fat fraction (PDFF). The liver's fat fractions were determined at baseline and 5 years later, and the frequency of participants who developed fatty liver disease and potential influencing factors were explored. Based on significant factors, a model was generated to predict the development of fatty liver disease. RESULTS: After excluding participants with pre-existing fatty liver, the baseline PDFF of 3.1 ± 0.9% (n = 190) significantly increased to 7.67 ± 3.39% within 5 years (p < 0.001). At baseline, age (OR = 1.04, p = 0.006, CI = 1.01-1.07), BMI (OR = 1.11, p = 0.041, CI = 1.01-1.23), and waist circumference (OR = 1.05, p = 0.020, CI = 1.01-1.09) were identified as risk factors. Physical activity was negatively associated (OR = 0.43, p = 0.049, CI = 0.18-0.99). In the prediction model, age, physical activity, diabetes mellitus, diastolic blood pressure, and HDL-cholesterol remained as independent variables. Combining these risk factors to predict the development of fatty liver disease revealed an AUC of 0.7434. CONCLUSIONS: Within a five-year follow-up, one-quarter of participants developed fatty liver disease influenced by the triggering factors of age, diabetes mellitus, low HDL-cholesterol, and diastolic blood pressure. Increased physical activity has a protective effect on the development of fatty liver.


Subject(s)
Magnetic Resonance Imaging , Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Female , Middle Aged , Male , Risk Factors , Longitudinal Studies , Liver/diagnostic imaging , Liver/pathology , Adult , Body Mass Index , Waist Circumference , Aged , Age Factors , Exercise
13.
World J Gastroenterol ; 30(25): 3132-3139, 2024 Jul 07.
Article in English | MEDLINE | ID: mdl-39006380

ABSTRACT

In this editorial, we comment on the article by Chen et al. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a global public health burden whose incidence has risen concurrently with overweight and obesity. Given its detrimental health impact, early identification of at-risk individuals is crucial. MAFLD diagnosis is based on evidence of hepatic steatosis indicated by liver biopsy, imaging, or blood biomarkers, and one of the following conditions: Overweight/ obesity, type 2 diabetes mellitus, or metabolic dysregulation. However, in large-scale epidemiological studies, liver biopsies are not feasible. The application of techniques such as ultrasonography, computed tomography, magnetic resonance imaging, and magnetic resonance spectroscopy is restricted by their limited sensitivity, low effectiveness, high costs, and need for specialized software. Blood biomarkers offer several advantages, particularly in large-scale epidemiological studies or clinical scenarios where traditional imaging techniques are impractical. Analysis of cumulative effects of excess high-normal blood alanine aminotransferase (ALT) levels of blood ALT levels could facilitate identification of at-risk patients who might not be detected through conventional imaging methods. Accordingly, investigating the utility of blood biomarkers in MAFLD should enhance early detection and monitoring, enabling timely intervention and management and improving patient outcomes.


Subject(s)
Alanine Transaminase , Biomarkers , Humans , Biomarkers/blood , Alanine Transaminase/blood , Liver/diagnostic imaging , Liver/pathology , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/blood , Non-alcoholic Fatty Liver Disease/epidemiology , Risk Factors , Obesity/complications , Obesity/diagnosis , Obesity/blood , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Early Diagnosis
14.
World J Gastroenterol ; 30(25): 3166-3178, 2024 Jul 07.
Article in English | MEDLINE | ID: mdl-39006386

ABSTRACT

BACKGROUND: Integrating conventional ultrasound features with 2D shear wave elastography (2D-SWE) can potentially enhance preoperative hepatocellular carcinoma (HCC) predictions. AIM: To develop a 2D-SWE-based predictive model for preoperative identification of HCC. METHODS: A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital. The patients were divided into the modeling group (n = 720) and the control group (n = 164). The study included conventional ultrasound, 2D-SWE, and preoperative laboratory tests. Multiple logistic regression was used to identify independent predictive factors for malignant liver lesions, which were then depicted as nomograms. RESULTS: In the modeling group analysis, maximal elasticity (Emax) of tumors and their peripheries, platelet count, cirrhosis, and blood flow were independent risk indicators for malignancies. These factors yielded an area under the curve of 0.77 (95% confidence interval: 0.73-0.81) with 84% sensitivity and 61% specificity. The model demonstrated good calibration in both the construction and validation cohorts, as shown by the calibration graph and Hosmer-Lemeshow test (P = 0.683 and P = 0.658, respectively). Additionally, the mean elasticity (Emean) of the tumor periphery was identified as a risk factor for microvascular invasion (MVI) in malignant liver tumors (P = 0.003). Patients receiving antiviral treatment differed significantly in platelet count (P = 0.002), Emax of tumors (P = 0.033), Emean of tumors (P = 0.042), Emax at tumor periphery (P < 0.001), and Emean at tumor periphery (P = 0.003). CONCLUSION: 2D-SWE's hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions, correlating significantly with MVI and antiviral treatment efficacy.


Subject(s)
Carcinoma, Hepatocellular , Elasticity Imaging Techniques , Liver Neoplasms , Liver , Humans , Elasticity Imaging Techniques/methods , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Female , Retrospective Studies , Middle Aged , Aged , Liver/diagnostic imaging , Liver/pathology , Liver/surgery , Predictive Value of Tests , Hepatectomy , Nomograms , Adult , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/pathology , Risk Factors , Sensitivity and Specificity
15.
Bioconjug Chem ; 35(7): 971-980, 2024 Jul 17.
Article in English | MEDLINE | ID: mdl-38958375

ABSTRACT

Conventional serum markers often fail to accurately detect cholestasis accompanying many liver diseases. Although elevation in serum bile acid (BA) levels sensitively reflects impaired hepatobiliary function, other factors altering BA pool size and enterohepatic circulation can affect these levels. To develop fluorescent probes for extracorporeal noninvasive hepatobiliary function assessment by real-time monitoring methods, 1,3-dipolar cycloaddition reactions were used to conjugate near-infrared (NIR) fluorochromes with azide-functionalized BA derivatives (BAD). The resulting compounds (NIRBADs) were chromatographically (FC and PTLC) purified (>95%) and characterized by fluorimetry, 1H NMR, and HRMS using ESI ionization coupled to quadrupole TOF mass analysis. Transport studies using CHO cells stably expressing the BA carrier NTCP were performed by flow cytometry. Extracorporeal fluorescence was detected in anesthetized rats by high-resolution imaging analysis. Three NIRBADs were synthesized by conjugating alkynocyanine 718 with cholic acid (CA) at the COOH group via an ester (NIRBAD-1) or amide (NIRBAD-3) spacer, or at the 3α-position by a triazole link (NIRBAD-2). NIRBADs were efficiently taken up by cells expressing NTCP, which was inhibited by taurocholic acid (TCA). Following i.v. administration of NIRBAD-3 to rats, liver uptake and consequent release of NIR fluorescence could be extracorporeally monitored. This transient organ-specific handling contrasted with the absence of release to the intestine of alkynocyanine 718 and the lack of hepatotropism observed with other probes, such as indocyanine green. NIRBAD-3 administration did not alter serum biomarkers of hepatic and renal toxicity. NIRBADs can serve as probes to evaluate hepatobiliary function by noninvasive extracorporeal methods.


Subject(s)
Bile Acids and Salts , Fluorescent Dyes , Liver , Animals , Bile Acids and Salts/chemistry , Fluorescent Dyes/chemistry , Rats , Liver/metabolism , Liver/diagnostic imaging , CHO Cells , Cricetulus , Liver Function Tests/methods , Male , Spectroscopy, Near-Infrared/methods , Rats, Sprague-Dawley , Fluorescence
16.
PLoS One ; 19(7): e0305725, 2024.
Article in English | MEDLINE | ID: mdl-39028708

ABSTRACT

BACKGROUND AND OBJECTIVE: The measurement of portal venous pressure (PVP) has been extensively studied, primarily through indirect methods. However, the potential of ultrasound-guided percutaneous transhepatic PVP measurement as a direct method has been largely unexplored. This study aimed to investigate the accuracy, safety, and feasibility of this approach. METHODS: In vitro, the experiment aimed to select a needle that could accurately transmit pressure, had a small inner diameter and was suitable for liver puncture, and performed on 20 healthy New Zealand white rabbits. An ultrasound-guided percutaneous transhepatic portal vein puncture was undertaken to measure PVP. Additionally, free hepatic venous pressure (FHVP) and wedged hepatic venous pressure (WHVP) were measured under digital subtraction angiography (DSA). The correlation between the two methods was assessed. Enroll study participants from October 18, 2023 to November 11, 2023 with written informed consent. Five patients were measured the PVP under ultrasound guidance before surgery to determine the feasibility of this measurement method. RESULTS: There was no significant difference in the results obtained using 9 different types of needles (P > 0.05). This demonstrated a great repeatability (P < 0.05). The 22G chiba needle with small inner diameter, allowing for accurate pressure transmission and suitable for liver puncture, was utilized for percutaneous transhepatic PVP measurement. There were positive correlations between PVP and HVPG (r = 0.881), PVP and WHVP (r = 0.709), HVPG and WHVP (r = 0.729), IVCP and FHVP (r = 0.572). The PVP was accurately and safely measured in 5 patients with segmental hepatectomy. No complications could be identified during postoperative ultrasound. CONCLUSION: Percutaneous transhepatic portal venous puncture under ultrasound guidance is accurate, safe and feasible to measure portal venous pressure. CLINICAL TRIAL REGISTRATION NUMBER: This study has been registered in the Chinese Clinical Trial Registry with registration number ChiCTR2300076751.


Subject(s)
Feasibility Studies , Portal Pressure , Portal Vein , Animals , Rabbits , Humans , Male , Female , Portal Vein/diagnostic imaging , Middle Aged , Ultrasonography, Interventional/methods , Adult , Liver/diagnostic imaging , Liver/surgery , Liver/blood supply , Punctures/methods , Ultrasonography/methods , Aged , Angiography, Digital Subtraction/methods , Blood Pressure Determination/methods
17.
Sci Rep ; 14(1): 16507, 2024 Jul 17.
Article in English | MEDLINE | ID: mdl-39019969

ABSTRACT

This study comprehensively explores the clinical characteristics, diagnostic approaches, and treatment methods for liver mucinous cystic neoplasms (MCN). A retrospective analysis was conducted on seven individuals diagnosed with MCN, admitted to the Fifth Medical Center of the PLA General Hospital between October 2016 and May 2023. Preoperative AFP was negative, while CA19-9 was elevated in two cases. Surgical resection was performed for all patients. The patients showed favorable postoperative recovery. Follow-up revealed an excellent overall survival rate, except for one case of invasive carcinoma resulting in tumor recurrence and metastasis 6 months after surgery. MCN poses a diagnostic challenge due to the absence of distinct clinical and radiological features, leading to potential misdiagnosis and inappropriate treatment. Patients with suspected liver cystic diseases should consider the possibility of MCN. Surgical resection has proven to be a practical approach with satisfactory therapeutic outcomes.


Subject(s)
Liver Neoplasms , Humans , Female , Male , Middle Aged , Retrospective Studies , Liver Neoplasms/diagnosis , Liver Neoplasms/pathology , Liver Neoplasms/therapy , Liver Neoplasms/surgery , Adult , Aged , Liver/pathology , Liver/surgery , Liver/metabolism , Liver/diagnostic imaging , Treatment Outcome
18.
Anat Histol Embryol ; 53(4): e13086, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38965883

ABSTRACT

Medical imaging techniques such as digital radiography and ultrasonography are non-invasive and provide precise results for examining internal organs and structures within fish. Their effectiveness can be further enhanced by using body parts like scales as markers for the organs beneath them. This study utilized the number of scales as landmarks in digital radiography and ultrasonography to non-invasively evaluate the muscles, bones, and images of internal and reproductive organs of common carp (Cyprinus carpio). Digital radiography was performed in the dorsoventral and lateral views of the fish, whereas ultrasonography was conducted in longitudinal and transverse views on sequence scale numbers with brightness and colour Doppler-modes. Digital radiography of the common carp revealed the whole-body morphology, including the bony parts from the head, pectoral fins, dorsal fins, pelvic fins, anal fins, and vertebrae to the tail that appeared radiopaque. Internal organs were also observed, with the swim bladder and heart appeared radiolucent, while the intestines, liver, testes, and ovaries appeared radiopaque. Ultrasonography in brightness mode displayed the digestive organs, reproductive organs, and muscle thickness. Additionally, colour Doppler mode demonstrated blood flow within the heart's ventricle.


Subject(s)
Carps , Animals , Carps/anatomy & histology , Female , Male , Ultrasonography/veterinary , Ultrasonography/methods , Radiographic Image Enhancement/methods , Animal Scales/anatomy & histology , Animal Scales/diagnostic imaging , Ultrasonography, Doppler, Color/veterinary , Ultrasonography, Doppler, Color/methods , Anatomic Landmarks/diagnostic imaging , Anatomic Landmarks/anatomy & histology , Liver/diagnostic imaging , Liver/anatomy & histology , Bone and Bones/diagnostic imaging , Bone and Bones/anatomy & histology
19.
Nat Commun ; 15(1): 5832, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38992020

ABSTRACT

While second near-infrared (NIR-II) fluorescence imaging is a promising tool for real-time surveillance of surgical operations, the previously reported organic NIR-II luminescent materials for in vivo imaging are predominantly activated by expensive lasers or X-ray with high power and poor illumination homogeneity, which significantly limits their clinical applications. Here we report a white-light activatable NIR-II organic imaging agent by taking advantages of the strong intramolecular/intermolecular D-A interactions of conjugated Y6CT molecules in nanoparticles (Y6CT-NPs), with the brightness of as high as 13315.1, which is over two times that of the brightest laser-activated NIR-II organic contrast agents reported thus far. Upon white-light activation, Y6CT-NPs can achieve not only in vivo imaging of hepatic ischemia reperfusion, but also real-time monitoring of kidney transplantation surgery. During the surgery, identification of the renal vasculature, post-reconstruction assessment of renal allograft vascular integrity, and blood supply analysis of the ureter can be vividly depicted by using Y6CT-NPs with high signal-to-noise ratios upon clinical laparoscopic LED white-light activation. Our work provides efficient molecular design guidelines towards white-light activatable imaging agent and highlights an opportunity for precision imaging theranostics.


Subject(s)
Optical Imaging , Surgery, Computer-Assisted , Animals , Surgery, Computer-Assisted/methods , Mice , Optical Imaging/methods , Light , Nanostructures/chemistry , Kidney Transplantation/methods , Humans , Liver/diagnostic imaging , Liver/surgery , Nanoparticles/chemistry , Infrared Rays , Luminescence , Kidney/diagnostic imaging , Kidney/surgery , Male , Spectroscopy, Near-Infrared/methods , Contrast Media/chemistry
20.
Sci Rep ; 14(1): 15264, 2024 07 03.
Article in English | MEDLINE | ID: mdl-38961124

ABSTRACT

This study evaluated the use of F-18 fluorodeoxyglucose (FDG) PET/CT imaging to differentiate between scrub typhus and systemic lupus erythematosus (SLE) in patients presenting with lymphadenopathy. We carried out a retrospective analysis of 18 scrub typhus patients and seven SLE patients, using various imaging parameters, including lymph node size, spleen and liver lengths, the distance between the two farthest lesions (Dmax), and assessments of glucose metabolism. On FDG PET images, we measured the maximum standardized uptake value (SUVmax) of the lymph nodes, spleen, and liver and the mean standardized uptake value (SUVmean) of the liver and spleen. The Dmax values of scrub typhus patients were significantly longer than those of SLE patients, indicating that lymphadenopathy is more generalized in the patients with scrub typhus. The SUVmax values for the lymph node, spleen, and liver were also higher in patients with scrub typhus, while the SUVmean of the liver and spleen did not differ between the two groups. This study is the first to compare FDG PET/CT images between these two conditions, suggesting the potential of this imaging modality to provide critical diagnostic distinctions.


Subject(s)
Fluorodeoxyglucose F18 , Lupus Erythematosus, Systemic , Positron Emission Tomography Computed Tomography , Scrub Typhus , Humans , Scrub Typhus/diagnostic imaging , Lupus Erythematosus, Systemic/diagnostic imaging , Lupus Erythematosus, Systemic/complications , Positron Emission Tomography Computed Tomography/methods , Female , Male , Middle Aged , Adult , Retrospective Studies , Aged , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Spleen/diagnostic imaging , Spleen/pathology , Liver/diagnostic imaging , Liver/pathology , Liver/metabolism , Diagnosis, Differential , Radiopharmaceuticals , Young Adult
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