The Experts below are selected from a list of 252 Experts worldwide ranked by ideXlab platform

Ming Zhang - One of the best experts on this subject based on the ideXlab platform.

  • point shear wave elastography to evaluate and monitor changing Portal Venous Pressure in patients with decompensated cirrhosis
    Ultrasound in Medicine and Biology, 2017
    Co-Authors: Hao Han, Jian Yang, Yuzheng Zhuge, Ming Zhang
    Abstract:

    This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with Portal Venous Pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP. We also analyzed whether change in SWV (ΔSWV) correlates with ΔPVP. The correlations were assessed with Spearman's rank correlation coefficients. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of ΔSWV. Spleen stiffness (SS) was positively correlated with PVP before and after TIPS (p < 0.002), although no correlation between liver stiffness and PVP was detected. A strong relationship between ΔSWV in SS and ΔPVP change in Portal hypertension (r = 0.871) was also found in the overall population. The area under the ROC curve for the diagnosis of TIPS technical success was 0.869 and at a ΔSWV cut-off value of 0.36 m/s sensitivity was 77%. Measurement of SS can be used for non-invasive assessment and monitoring of PVP in patients with decompensated cirrhosis.

  • Point Shear Wave Elastography to Evaluate and Monitor Changing Portal Venous Pressure in Patients with Decompensated Cirrhosis.
    Ultrasound in medicine & biology, 2017
    Co-Authors: Hao Han, Jian Yang, Yuzheng Zhuge, Ming Zhang
    Abstract:

    This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with Portal Venous Pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP. We also analyzed whether change in SWV (ΔSWV) correlates with ΔPVP. The correlations were assessed with Spearman's rank correlation coefficients. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of ΔSWV. Spleen stiffness (SS) was positively correlated with PVP before and after TIPS (p 

Jun Liong Chin - One of the best experts on this subject based on the ideXlab platform.

  • patterns of splenic arterial enhancement on computed tomography are related to changes in Portal Venous Pressure
    European Journal of Gastroenterology & Hepatology, 2019
    Co-Authors: Aiden P Mccormick, Dermot E Malone, James R Docherty, Clifford Kiat, Brian Christopher, Jun Liong Chin
    Abstract:

    OBJECTIVES One of the striking features of splenic imaging is variable heterogeneous gyriform arterial enhancement on dynamic computed tomography (CT). We speculated that these patterns of arterial enhancement may reflect changes in splenic micro-circulation related to changes in Portal Venous Pressure. PATIENTS AND METHODS To test this hypothesis, we evaluated arterial phase CT scans performed before and after liver transplantation (n=91), as this is the most effective way of alleviating Portal hypertension. We developed novel grading systems to assess heterogeneity. Two control groups were used: patients with cirrhosis undergoing transarterial chemoembolization (TACE) (n=28) and patients with cirrhosis on the liver transplant waiting list who had repeated CT scans (n=28). RESULTS Splenic arterial heterogeneity increased in 55% of transplant patients compared with 14% in the TACE patients and 4% in the waiting list patients (P<0.0001). Mean Hounsfield units in areas of splenic enhancement were 71.7±2 before transplant and 90.1±2.5 after transplant (P<0.01). In contrast, there were no significant changes following TACE (86.3±4.2 vs. 83.5±4.5; P=NS) or in waiting list patients (80.9±4.6 vs. 73.8±3.7; P=NS). CONCLUSION We have shown the heterogeneous gyriform enhancement patterns significantly increase following liver transplantation but not after TACE or in waiting list patients. We suggest that these changes are due to the reduction in Portal Venous Pressure and likely reflect changes in splenic micro-circulation. These changes may be important in the pathophysiology of hypersplenism.

  • Patterns of splenic arterial enhancement on computed tomography are related to changes in Portal Venous Pressure.
    European journal of gastroenterology & hepatology, 2019
    Co-Authors: P. Aiden Mccormick, Dermot E Malone, James R Docherty, Clifford Kiat, Brian Christopher, Jun Liong Chin
    Abstract:

    OBJECTIVES One of the striking features of splenic imaging is variable heterogeneous gyriform arterial enhancement on dynamic computed tomography (CT). We speculated that these patterns of arterial enhancement may reflect changes in splenic micro-circulation related to changes in Portal Venous Pressure. PATIENTS AND METHODS To test this hypothesis, we evaluated arterial phase CT scans performed before and after liver transplantation (n=91), as this is the most effective way of alleviating Portal hypertension. We developed novel grading systems to assess heterogeneity. Two control groups were used: patients with cirrhosis undergoing transarterial chemoembolization (TACE) (n=28) and patients with cirrhosis on the liver transplant waiting list who had repeated CT scans (n=28). RESULTS Splenic arterial heterogeneity increased in 55% of transplant patients compared with 14% in the TACE patients and 4% in the waiting list patients (P

Kyuichi Tanikawa - One of the best experts on this subject based on the ideXlab platform.

  • Effects of vasopressin and nicardipine on hemodynamics and liver function in patients with cirrhosis: comparison with vasopressin alone
    Journal of Hepatology, 2005
    Co-Authors: Tadashi Iwao, Atsushi Toyonaga, Motoki Ikegami, Kazuhiko Oho, Michihiro Sumino, Munenori Sakaki, Hiroyuki Shigemori, Masafumi Nakayama, Ei Sasaki, Kyuichi Tanikawa
    Abstract:

    The effects of a combination of vasopressin and a calcium channel blocker (nicardipine) on portohepatic hemodynamics and liver function were compared with the effects of vasopressin alone in 18 patients with Portal hypertension. Nine patients received 0.4 units/min of vasopressin and 9 patients received the same dose of vasopresin plus 0.3 mg/min of nicardipine for 40 min. Vasopressin plus nicardipine induced a significant reduction in both free Portal Venous Pressure and the Portal Venous Pressure gradient. These effects were similar to the changes with vasopressin alone (−14% vs. −16% in free Portal Venous Pressure; −29% vs. −31% in Portal Venous Pressure gradient). Vasopressin decreased both hepatic blood flow (−34%, P

  • Reduced Contractility and Histological Changes in the Gallbladder due to Portal Hypertension in a Hamster Cirrhosis Model
    Digestion, 1997
    Co-Authors: Ryuichiro Sakata, Takato Ueno, Takuji Torimura, Michio Sata, Kyuichi Tanikawa
    Abstract:

    Background/Aims: Little is known about the relationship of Portal Venous Pressure to contractility and histological changes in the gallbladder. In this study, we investigated the relationship between Portal hypertension and contractility and histological changes in the gallbladder in a hamster cirrhosis model. Methods: Liver cirrhosis was induced in the hamsters (n = 20) by thioacetamide (TAA). Portal Venous Pressure was directly measured using a Pressure-measuring instrument. The contractility of the gallbladder was appraised by the diameter before and after caerulein treatment. Gallbladder wall thickness and vessel areas in tissues were evaluated in relation to the Portal Venous Pressure. Results: The Portal Venous Pressure, gallbladder wall thickness with submucosal edema and area of vessels in the gallbladder wall in the cirrhosis group were significantly increased compared with those in the control group (n = 20, receiving saline instead of TAA). The gallbladder contraction rate in the cirrhosis group was significantly decreased compared with that in the control group. In the cirrhosis group, there were positive correlations between the Portal Venous Pressure and the gallbladder contraction rate, gallbladder wall thickness, and area of vessels. Conclusions: In the gallbladders of experimental cirrhotic hamsters, Portal hypertension caused dilatation of the vessels as well as submucosal edema, and was an important factor in the increased thickness and reduced contractility of the gallbladder wall.

  • Wedged hepatic Venous Pressure reflects Portal Venous Pressure during vasoactive drug administration in nonalcoholic cirrhosis
    Digestive diseases and sciences, 1994
    Co-Authors: Tadashi Iwao, Atsushi Toyonaga, Motoki Ikegami, Kazuhiko Oho, Michihiro Sumino, Munenori Sakaki, Hiroyuki Shigemori, Masafumi Nakayama, Kyuichi Tanikawa
    Abstract:

    Hepatic Venous catheterization is widely used to assess Portal Pressure. However, it remains unclear whether wedged hepatic Venous Pressure is a close indicator of Portal Venous Pressure during vasoactive drug administration in nonalcoholic cirrhosis. To address this issue, we analyzed the data from our previous published studies. Forty patients with nonalcoholic cirrhosis (HBV infection in five, HCV infection in 28, and cryptogenic in seven) were available in this analysis. A vasoconstrictor (N=14), vasodilator (N=10), or combination (N=16) was administered. The agreement of the changes between Portal and wedged hepatic Venous Pressures during pharmacological manipulation was assessed by an intraclass correlation coefficient. The intraclass correlation coefficient in each subgroup was more than 0.60 (0.62 in vasoconstrictor group, 0.87 in vasodilator group, and 0.73 in combination group). When the analysis was performed according to the cause of liver disease, the values were 0.67 in HBV infection, 0.73 in HCV infection, and 0.74 in cryptogenic cirrhosis. These results suggest that wedged hepatic Venous Pressure reflects Portal Venous Pressure during vasoactive drug administration in patients with nonalcoholic cirrhosis.

David L. Bigam - One of the best experts on this subject based on the ideXlab platform.

  • Portal Venous Pressure changes after sequential clinical islet transplantation.
    Transplantation, 2002
    Co-Authors: John J. Casey, Jonathan R. T. Lakey, Edmond A. Ryan, Breay W. Paty, Richard J. Owen, Kevin O'kelly, Sulaiman A. Nanji, Ray V. Rajotte, Gregory S. Korbutt, David L. Bigam
    Abstract:

    BACKGROUND Sequential pancreatic islet transplantation via the Portal vein has led to insulin independence in patients with type 1 diabetes. Complications associated with the injection of islets into the Portal vein have been reported; therefore, in this study we sought to further characterize changes in Portal Venous Pressure associated with islet infusion. METHODS Pre- and posttransplant Portal Venous Pressures were recorded in 50 consecutive transplant procedures in 26 patients receiving highly purified, heparinized allogeneic islet preparations via a radiologically placed Portal Venous cannula. Doppler ultrasound scans of the Portal vein were completed within 24 hr of transplantation. RESULTS Posttransplant Portal vein Pressures rose significantly with sequential transplantation (12.4 mm Hg vs. 17.3 mm Hg, P

  • Portal Venous Pressure changes after sequential clinical islet transplantation
    Transplantation, 2002
    Co-Authors: John J. Casey, Jonathan R. T. Lakey, Edmond A. Ryan, Breay W. Paty, Richard J. Owen, Sulaiman A. Nanji, Ray V. Rajotte, Gregory S. Korbutt, Kevin Okelly, David L. Bigam
    Abstract:

    BACKGROUND Sequential pancreatic islet transplantation via the Portal vein has led to insulin independence in patients with type 1 diabetes. Complications associated with the injection of islets into the Portal vein have been reported; therefore, in this study we sought to further characterize changes in Portal Venous Pressure associated with islet infusion. METHODS Pre- and posttransplant Portal Venous Pressures were recorded in 50 consecutive transplant procedures in 26 patients receiving highly purified, heparinized allogeneic islet preparations via a radiologically placed Portal Venous cannula. Doppler ultrasound scans of the Portal vein were completed within 24 hr of transplantation. RESULTS Posttransplant Portal vein Pressures rose significantly with sequential transplantation (12.4 mm Hg vs. 17.3 mm Hg, P <0.05). Portal Pressure change correlated significantly with islet packed cell volume (r =0.66, P <0.001) and also with the number of islets transplanted ( r=0.49, P <0.001). Segmental Portal vein thrombosis was radiologically detected after two procedures (4%). CONCLUSION Multiple sequential islet transplants can be safely performed via the Portal vein, provided that care is taken with islet purification and attention is paid to Portal Venous monitoring.

Hao Han - One of the best experts on this subject based on the ideXlab platform.

  • point shear wave elastography to evaluate and monitor changing Portal Venous Pressure in patients with decompensated cirrhosis
    Ultrasound in Medicine and Biology, 2017
    Co-Authors: Hao Han, Jian Yang, Yuzheng Zhuge, Ming Zhang
    Abstract:

    This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with Portal Venous Pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP. We also analyzed whether change in SWV (ΔSWV) correlates with ΔPVP. The correlations were assessed with Spearman's rank correlation coefficients. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of ΔSWV. Spleen stiffness (SS) was positively correlated with PVP before and after TIPS (p < 0.002), although no correlation between liver stiffness and PVP was detected. A strong relationship between ΔSWV in SS and ΔPVP change in Portal hypertension (r = 0.871) was also found in the overall population. The area under the ROC curve for the diagnosis of TIPS technical success was 0.869 and at a ΔSWV cut-off value of 0.36 m/s sensitivity was 77%. Measurement of SS can be used for non-invasive assessment and monitoring of PVP in patients with decompensated cirrhosis.

  • Point Shear Wave Elastography to Evaluate and Monitor Changing Portal Venous Pressure in Patients with Decompensated Cirrhosis.
    Ultrasound in medicine & biology, 2017
    Co-Authors: Hao Han, Jian Yang, Yuzheng Zhuge, Ming Zhang
    Abstract:

    This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with Portal Venous Pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP. We also analyzed whether change in SWV (ΔSWV) correlates with ΔPVP. The correlations were assessed with Spearman's rank correlation coefficients. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of ΔSWV. Spleen stiffness (SS) was positively correlated with PVP before and after TIPS (p