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Volker Keim - One of the best experts on this subject based on the ideXlab platform.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers.
Ultraschall in der Medizin (Stuttgart Germany : 1980), 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization. © Georg Thieme Verlag KG Stuttgart · New York.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in
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assessment of spleen stiffness using acoustic radiation force impulse imaging arfi definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. Conclusion: ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization.
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acoustic radiation force impulse imaging arfi for non invasive detection of liver fibrosis Examination Standards and evaluation of interlobe differences in healthy subjects and chronic liver disease
Scandinavian Journal of Gastroenterology, 2011Co-Authors: Thomas Karlas, M Tröltzsch, C Pfrepper, J Wiegand, Christian Wittekind, Marie Neuschulz, J Mossner, T Berg, Volker KeimAbstract:Abstract Objective. Acoustic radiation force impulse imaging (ARFI) is a non-invasive method for the quantification of liver stiffness. We aimed to develop Standards for the measuring procedure and studied the impact of different measuring sites. Materials and Methods. ARFI was tested in a tissue phantom and in 50 healthy volunteers. In addition, 116 patients with chronic liver disease underwent ARFI. The results were compared with histological staging (non-viral liver disease) and transient elastography (hepatitis C). ARFI diagnostic performance was evaluated with receiver operating characteristic curves. Results. ARFI results were not normally distributed in >20% of cases. Deep inspiration significantly increased ARFI values by 13% (p < 0.05). The mean shear-wave velocity in healthy individuals was 1.28 ± 0.19 m/s in the left liver lobe and 1.15 ± 0.17 m/s in the right liver lobe (p < 0.001). Similarly, in 79/116 patients with chronic liver disease a significant difference of shear-wave velocity between...
Thomas Karlas - One of the best experts on this subject based on the ideXlab platform.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers.
Ultraschall in der Medizin (Stuttgart Germany : 1980), 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization. © Georg Thieme Verlag KG Stuttgart · New York.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in
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assessment of spleen stiffness using acoustic radiation force impulse imaging arfi definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. Conclusion: ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization.
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acoustic radiation force impulse imaging arfi for non invasive detection of liver fibrosis Examination Standards and evaluation of interlobe differences in healthy subjects and chronic liver disease
Scandinavian Journal of Gastroenterology, 2011Co-Authors: Thomas Karlas, M Tröltzsch, C Pfrepper, J Wiegand, Christian Wittekind, Marie Neuschulz, J Mossner, T Berg, Volker KeimAbstract:Abstract Objective. Acoustic radiation force impulse imaging (ARFI) is a non-invasive method for the quantification of liver stiffness. We aimed to develop Standards for the measuring procedure and studied the impact of different measuring sites. Materials and Methods. ARFI was tested in a tissue phantom and in 50 healthy volunteers. In addition, 116 patients with chronic liver disease underwent ARFI. The results were compared with histological staging (non-viral liver disease) and transient elastography (hepatitis C). ARFI diagnostic performance was evaluated with receiver operating characteristic curves. Results. ARFI results were not normally distributed in >20% of cases. Deep inspiration significantly increased ARFI values by 13% (p < 0.05). The mean shear-wave velocity in healthy individuals was 1.28 ± 0.19 m/s in the left liver lobe and 1.15 ± 0.17 m/s in the right liver lobe (p < 0.001). Similarly, in 79/116 patients with chronic liver disease a significant difference of shear-wave velocity between...
M Tröltzsch - One of the best experts on this subject based on the ideXlab platform.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers.
Ultraschall in der Medizin (Stuttgart Germany : 1980), 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization. © Georg Thieme Verlag KG Stuttgart · New York.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in
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assessment of spleen stiffness using acoustic radiation force impulse imaging arfi definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. Conclusion: ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization.
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acoustic radiation force impulse imaging arfi for non invasive detection of liver fibrosis Examination Standards and evaluation of interlobe differences in healthy subjects and chronic liver disease
Scandinavian Journal of Gastroenterology, 2011Co-Authors: Thomas Karlas, M Tröltzsch, C Pfrepper, J Wiegand, Christian Wittekind, Marie Neuschulz, J Mossner, T Berg, Volker KeimAbstract:Abstract Objective. Acoustic radiation force impulse imaging (ARFI) is a non-invasive method for the quantification of liver stiffness. We aimed to develop Standards for the measuring procedure and studied the impact of different measuring sites. Materials and Methods. ARFI was tested in a tissue phantom and in 50 healthy volunteers. In addition, 116 patients with chronic liver disease underwent ARFI. The results were compared with histological staging (non-viral liver disease) and transient elastography (hepatitis C). ARFI diagnostic performance was evaluated with receiver operating characteristic curves. Results. ARFI results were not normally distributed in >20% of cases. Deep inspiration significantly increased ARFI values by 13% (p < 0.05). The mean shear-wave velocity in healthy individuals was 1.28 ± 0.19 m/s in the left liver lobe and 1.15 ± 0.17 m/s in the right liver lobe (p < 0.001). Similarly, in 79/116 patients with chronic liver disease a significant difference of shear-wave velocity between...
F. Lindner - One of the best experts on this subject based on the ideXlab platform.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers.
Ultraschall in der Medizin (Stuttgart Germany : 1980), 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization. © Georg Thieme Verlag KG Stuttgart · New York.
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Assessment of spleen stiffness using acoustic radiation force impulse imaging (ARFI): definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in
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assessment of spleen stiffness using acoustic radiation force impulse imaging arfi definition of Examination Standards and impact of breathing maneuvers
Ultraschall in Der Medizin, 2014Co-Authors: Thomas Karlas, F. Lindner, M Tröltzsch, Volker KeimAbstract:Purpose: Spleen elastography is a promising method for the characterization of portal hypertension in cirrhotic individuals. However, standardized Examination procedures for spleen stiffness measurement have not been defined yet. We analyzed the distribution characteristics of spleen shear-wave velocity (ARFI) and assessed the influence of the respiratory position on spleen stiffness measured by ARFI. Materials and Methods: 25 healthy probands and 25 patients with Child A liver cirrhosis were prospectively characterized with conventional ultrasound, transient elastography, liver ARFI, and underwent spleen ARFI in two respiratory positions: breath hold after expiration (exp) and deep inspiration (insp). For each position 20 single measurements were performed. The distribution of spleen ARFI values was analyzed for normality and the appropriate number of measurements for spleen stiffness estimation was investigated. Results: Spleen ARFI results were normally distributed in > 95 % of cases. Performing 20 instead of 10 single measurements resulted in < 5 % deviation from the mean value after 20 measurements in the majority of cases. Cirrhotic patients had a higher spleen stiffness compared to healthy probands (exp: 3.25 ± 0.58 vs. 2.46 ± 0.35 m/s; p < 0.001). Deep inspiration caused an overall increase in spleen stiffness in both groups: probands 2.46 ± 0.35 m/s (exp) vs. 2.66 ± 0.36 m/s (insp), p = 0.01; cirrhotics 3.25 ± 0.58 m/s (exp) vs. 3.46 ± 0.38 m/s (insp), p = 0.03. However, cases with high spleen stiffness values (exp) show decreasing ARFI values in deep inspiration. Conclusion: ARFI values of the spleen are normally distributed and the mean of 10 valid measurements can be used as a representative value. Deep inspiration significantly modulates spleen stiffness. Therefore, the respiratory position needs careful standardization.
J Older - One of the best experts on this subject based on the ideXlab platform.
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anatomy a must for teaching the next generation
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland, 2004Co-Authors: J OlderAbstract:Teaching anatomy to both undergraduate medical students and medical graduates is in the midst of a downward spiral. The traditional anatomy education based on topographical structural anatomy taught by didactic lectures and complete dissection of the body with personal tuition, has been replaced by a multiple range of special study modules, problem-based workshops, computers, plastic models and many other teaching tools. In some centres, dissected cadaver-based anatomy is no longer taught. Changing the undergraduate medical curriculum in the UK has taken place without any research into the key aspects of knowledge necessary or comparing methods of teaching. There is no agreement on a common national core curriculum and as a result, numerous new curricula have been introduced. No external audit or validation is carried out, so medical schools have been free to teach and assess their own work themselves. There is a great divergence in medical schools across the UK and Ireland in teaching medicine in general and anatomy in particular. Published data on the impact of these changes is scant. The reduction in undergraduate teaching and knowledge of anatomy has caused great concern, not only for undergraduates but also to postgraduate students, especially in surgery. This, together with a change in basic surgical training, a marked reduction in demonstrator posts and a change in Examination Standards, has set up a system that is allowing young men and women with a poor knowledge of anatomy to become surgeons. There should be a full public debate at every level; the Royal Colleges, specialist associations, the Universities, Government, both health and education. This debate should highlight areas of concern, explore in depth and define a minimal core curriculum for anatomy. Teaching must be enhanced with a critical look at both teachers and methods. The dominance of research must be reassessed to establish an equitable cohabitation with teaching. The place of basic science, especially anatomy in basic surgical teaching, must be examined. A thorough knowledge of anatomy should be required in the new MRCS-UK. This should be mandatory as a preliminary to higher surgical training. The teaching of anatomy in surgical specialities must be improved. Does the dissecting room still have a place in educating our under- and postgraduate students? Yes — a sound knowledge of anatomy is essential if the medical practitioner is going to accurately define and successfully treat the problem presented by the patient. The dissected cadaver remains the most powerful means of presenting and learning anatomy as a dynamic basis for solving problems. The cadaver must not be dismissed as obsolete. Dissection has survived the most rigorous test of pedagological fitness — the test of time. The student — cadaver — patient encounter is paramount in medical education
