Acoustic radiation force impulse elastography and contrast-enhanced sonography of sinusoidal obstructive syndrome (Veno-occlusive Disease): preliminary results.

We report quantitative liver acoustic radiation force impulse (ARFI) elastographic findings in 2 cases of sinusoidal obstructive syndrome and liver contrast-enhanced sonographic features in one of these cases. To our knowledge, findings in this condition from these techniques have not been reported previously. Acoustic radiation force impulse elastography showed median high shear wave velocities (case 1, 2.75 m/s; case 2, 2.58 m/s) that normalized after specific treatment for sinusoidal obstructive syndrome; therefore, ARFI elastography provided quantitative information that helped diagnose this condition as well as monitor the response to treatment. Contrast-enhanced sonographic findings in one of the cases showed patchy liver enhancement that correlated with the high-velocity patchy distribution on ARFI elastography in that case and enhanced multidetector row computed tomographic findings in the other case. This contrast-enhanced sonographic pattern progressively normalized during follow-up after specific treatment. The elastographic features in both cases and contrast-enhanced sonographic features in one of them contributed to early diagnosis and follow-up of sinusoidal obstructive syndrome in both patients. Further prospective studies are necessary to define the role of ARFI elastography and contrast-enhanced sonography in the early diagnosis and clinical follow-up of this condition.

Intravascular ultrasound measurement of the aortic lumen.

Intravascular ultrasound (IVUS) has been successfully used to guide the implantation of stents in the thoracic aorta. However, its accuracy in measuring the diameter of the aortic lumen has not been clearly established. Thirteen patients with thoracic aortic disease underwent IVUS, and lumen diameter measurements were compared with those obtained by CT or magnetic resonance imaging. A total of 31 comparable measurements were obtained. The correlation was good (r=0.98; P< .001), with IVUS tending to give a larger minimum diameter than CT (systematic error, 0.59+/-1.8 mm; P=.077). Given that the aorta is often not circular, the diameter obtained by IVUS was also compared to the mean diameter obtained by CT, and it was found that these two measurements were more closely related (P=.425), except in aortic segments with significant eccentricity (i.e., >10%). In conclusion, IVUS was a reliable tool for measuring the diameter of the aorta, particularly in concentric segments where stents are normally placed. Consequently, IVUS could supplement conventional imaging techniques.

Utilidad del ultrasonido intravascular para la medición de la luz aórtica / Intravascular ultrasound measurement of the aortic lumen

El ultrasonido intravascular (IVUS) se ha utilizado con éxito para guiar la implantación de endoprótesis en aorta torácica. Sin embargo, su precisión para medir la luz aórtica no está definitivamente establecida. Evaluamos con IVUS a 13 pacientes con enfermedad de la aorta torácica, comparando el diámetro luminal con las medidas de tomografía computarizada (TC) o resonancia magnética. Se obtuvieron 31 mediciones comparables. La correlación fue buena (r = 0,98; p < 0,001), con un ligero sesgo positivo del IVUS respecto al diámetro mínimo por TC (error sistemático, 0,59 ± 1,8 mm; p = 0,077). Dado que la aorta con frecuencia no es circular, se comparó también con el diámetro medio de la TC, obteniéndose mayor aproximación a las medidas de IVUS (p = 0,425), excepto en segmentos con excentricidad significativa (> 10%). En conclusión, el IVUS resulta fiable para la medición de diámetros aórticos, especialmente en segmentos concéntricos donde se fijan las endoprótesis, y puede complementar las técnicas de imagen convencionales (AU)

Intravascular ultrasound (IVUS) has been successfully used to guide the implantation of stents in the thoracic aorta. However, its accuracy in measuring the diameter of the aortic lumen has not been clearly established. Thirteen patients with thoracic aortic disease underwent IVUS, and lumen diameter measurements were compared with those obtained by CT or magnetic resonance imaging. A total of 31 comparable measurements were obtained. The correlation was good (r=0.98; P < .001), with IVUS tending to give a larger minimum diameter than CT (systematic error, 0.59±1.8 mm; P=.077). Given that the aorta is often not circular, the diameter obtained by IVUS was also compared to the mean diameter obtained by CT, and it was found that these two measurements were more closely related (P=.425), except in aortic segments with significant eccentricity (i.e., >10%). In conclusion, IVUS was a reliable tool for measuring the diameter of the aorta, particularly in concentric segments where stents are normally placed. Consequently, IVUS could supplement conventional imaging techniques (AU)