Abstracts 2004 Elevated serum AFP more than 100 ng/ml in chronic hepatitis B patients without HCC: Follow-up 5–12 MHz SonoCT findings of hepatic parenchyma Cha SH, Chung HH, Lee KY, Lee SH, Seo BK, Kim T-K, Je B-K, Kim BH, Ansan Hospital Korea University, Korea Objectives: To evaluate follow-up 5–12 MHz SonoCT findings of hepatic parenchyma with elevated serum alphofetoprotein (AFP) more than 100ng/ml (EAFP100) in chronic hepatitis B (CHB) patients without hepatocellular carcinoma (HCC). Methods: Total 23 CHB patients with EAFP100 were included in the study. Interval between the initial and the last 5–12 MHz SonoCT examination was ranged from 9 to 44 (average 23.5) months and EAFP100 was revealed 1 to 4 times (average 1.7/total 9.7 times) during that period. No HCC was detected at more than six months radiological and/or clinical follow-up after the last 5–12 MHz SonoCT examination. Two radiologists analyzed changes of 5–12 MHz SonoCT findings of hepatic parenchyma in consensus and statistical analysis was done. Results: Among 23 cases, 14 (61%) revealed changed and nine (39%) revealed unchanged 5–12MHz SonoCT finding. In changed group, eight (57%) showed normal-looking echo of liver initially but heterogenous echo, or multiple, small hypoechoic or hyperechoic nodules on the last examination. In unchanged group six (66%) showed diffuse hypoechoic-honeycomb echo on initial and last examination. Average follow up period of changed and unchanged group with 5–12 MHz SonoCT was 22. 4 and 20.2 months, respectively, and statistically insignificant (p ⫽ 0.924). Average serum AFP titer of changed and unchanged group was 83.52 and 39.8 ng/ml, respectively, but statistically insignificant (p ⫽ 0.052). Conclusions: Follow-up 5–12 MHz SonoCT can help to evaluate hepatic parenchyma with EAFP100 in CHB patients without HCC. 2005 Relation between indexes of spleen and G/S staging in chronic viral hepatitis Miao L, Wang J, Ge H, Peking University Third Hospital, China Objectives: To discuss the relation between indexes of spleen and G/S staging in chronic viral hepatitis. Methods: According to the pathology of needle biopsy, the liver fibrosis status was graded as S0 ⵑ S4, and the inflammatory reaction in the liver was graded as Gl ⵑ G4. The discrepancy of spleen indexes was compared between the case group and the control group and among G/S stagings. Results: The size of spleen, the inside diameter of splenic artery and vein, the blood flow of spleen were increased as the G/S staging and became higher as the patient’s condition became graver. These indexes were higher in case group than those in the control group. The correlation coefficients between SPT and D1SPV, Vs2SPV, SPFV, D2SPV, VsSPA were 0.510, 0.510, 0.447, 0.353, 0.353, respectively. Conclusions: The size of spleen, the inside diameters of splenic artery and vein, hemodynamic indexes of spleen are helpful to estimate the patient’s disease. 2006 Relation between pathological changes of gallbladder and G/S staging in chronic viral hepatitis Wang J, Miao L, Ge H, Peking University Third Hospital, China Objectives: To discuss the relation between pathological changes of gallbladder (GB) and G/S staging in chronic viral hepatitis. Methods: According to the pathology of needle biopsy, the status of hepatic fibrosis was graded as S0 ⵑ S4, and the inflammatory reaction
in the liver was graded as Gl ⵑ G4. The discrepancy of GB indexes were compared between the case group and the control group and among G/S stagings. Results: The size of GB and the thickness of the GB wall in the case group were larger and more thick than those in control group. So did the smooth rate of GB wall. Eight bilateral gallbladders were all occurred in case group. GB became larger as the G/S staging became higher, so did the smooth rate of GB wall and bilateral gallbladder. The value of GB indexes became higher as the patient’s condition became graver according to the inflammatory activity of the liver, so did the smooth rate of GB wall. Conclusions: Pathological changes of GB in chronic virus hepatitis were related with G/S stagings, the course of disease and the severity of chronic virus hepatitis. A serial observation was made to pathological changes of GB in chronic virus hepatitis which can help doctors to judge patient’s condition and provide the information for diagnosis and therapy. 2008 Weakness of visual grading in the diagnosis of fatty liver on ultrasound: Result from comparison with quantitative measurement Lee CH, Choi JW, Kim KA, Park CM, Guro Hospital, Korea University, Korea Objectives: To evaluate the weakness of visual grading for fatty liver (FL) through the comparison with hepatorenal echogenicity ratio (HER). Methods: The ultrasound was applied to 281 patients. The echogenicity of the liver was measured in three ROI close to the adjacent right kidney. Similar measurements were performed in the right renal cortex. The HER (mean liver/kidney echogenicity) was then calculated. The degree of hepatic echogenicity were classified into normal, mild, moderate, and severe using the reference figure on PACS. The statistical analysis for multiple comparison of the average HER of the four groups was carried out using a one-way ANOVA. Results: Among the 281 patients, there were 60 normal (mean HER: 1.33), 81 mild FL (mean 1.45), 86 moderate FL (mean 2.03) and 54 severe FL (mean 2.46). The HER of the normal and mild FL had no significant difference (p ⬎ 0.05), but there were significant differences (p ⬍ 0.01) between the mild FL and moderate FL, and the moderate FL and severe FL. Conclusions: The weakness of visual grading in the diagnosis of FL on ultrasound was differentiation of the mild FL from the normal. Therefore, we proposed that the HER be added as a quantitative value for the determination of the brightness of FL, especially in mild FL.
YOUNG INVESTIGATOR AWARD PRESENTATION (I) 2009 Detection of hepatocellular carcinoma capsule by contrastenhanced ultrasound using Levovist Bhattacharjee P, Saito A, Chiba M, Katagiri S, Katsuragawa H, Takasaki K, Tokyo Women’s Medical University, Japan Objectives: To investigate the diagnostic potential of contrast-enhanced ultrasound (CEUS) in the detection of hepatocellular carcinoma (HCC) capsule. Methods: Thirty-six HCC nodules (mean diameter; 2.3 cm) from 36 patients who had undergone hepatectomy were examined by CEUS using Levovist with agent detection imaging. We classified the appearance of the tumor artery, tumor enhancement and washout into several patterns on CEUS. The ultrasound findings and pathological findings