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| 1 | 为弥漫的甲状腺腺病理的评估的 ARFI elastography : 初步的结果显示文摘 AIM:To assess whether acoustic radiation force impulse(ARFI)elastography can differentiate normal from pathological thyroid parenchyma.METHODS:We evaluated 136 subjects(mean age 45.8±15.6 years,106 women and 30 men):44(32.3%) without thyroid pathology,48(35.3%)with BasedowGraves’disease(GD),37(27.2%)with chronic autoimmune thyroiditis(CAT;diagnosed by specific tests),4(2.9%)with diffuse thyroid goiter and 3(2.2%)cases with thyroid pathology induced by amiodarone.In all patients,10 elastographic measurements were made in the right thyroid lobe and 10 in the left thyroid lobe,using a 1-4.5 MHZ convex probe and a 4-9 MHz linear probe,respectively.Median values were calculated for thyroid stiffness and expressed in meters/second(m/s).RESULTS:Thyroid stiffness(TS)assessed by means of ARFI in healthy subjects(2±0.40 m/s)was significantly lower than in GD(2.67±0.53 m/s)(P<0.0001) and CAT patients(2.43±0.58 m/s)(P=0.0002),but the differences were not significant between GDvs CAT patients(P=0.053).The optimal cut-off value for the prediction of diffuse thyroid pathology was 2.36 m/s.For this cut-off value,TS had 62.5%sensitivity,79.5% specificity,87.6%predictive positive value,55.5% negative predictive value and 72.7%accuracy for the presence of diffuse thyroid gland pathology(AUROC=0.804).There were no significant differences between the TS values obtained with linear vs convex probes and when 5 vs 10 measurements were taken in each lobe(median values).CONCLUSION:ARFI seems to be a useful method for the assessment of diffuse thyroid gland pathology. | Ioan Sporea Roxana Sirli Simona Bota Mihaela Vlad Alina Popescu Ioana Zosin | 2012 | World Journal of Radiology2012，4，4： | 25 |
| 2 | Is ARFI elastography reliable for predicting fibrosis severity in chronic HCV hepatitis?显示文摘AIM:To determine whether acoustic radiation force impulse(ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus(HCV) hepatitis.METHODS:We performed a multicenter study including 274 subjects with HCV chronic hepatitis in which we compared ARFI with liver biopsy(LB).In each patient we performed LB(evaluated according to the Metavir score) and ARFI measurements(using a Siemens Acuson S2000TM ultrasound system:10 valid measurements were performed and median values were calculated and expressed in meters/second(m/s).RESULTS:A direct,strong,correlation(Spearman r = 0.707) was found between ARFI measurements and fibrosis(P < 0.0001).For predicting the presence of fibrosis(F ≥ 1 Metavir),significant fibrosis(F ≥ 2),severe fibrosis(F ≥ 3) and cirrhosis(F = 4),the cutoff values of 1.19,1.21,1.58 and 1.82 m/s were determined,respectively,liver stiffness measurements had 73%,84%,84% and 91% Se respectively;93%,91%,94%,90% Sp,respectively;with AUROCs of 0.880,0.893,0.908 and 0.937,respectively.CONCLUSION:ARFI measurement is a reliable method for predicting the severity of fibrosis in HCV | Ioan Sporea Roxana Sirli Simona Bota Carmen Fierbinteanu-Braticevici Alina Popescu Radu Badea Monica Lupsor Ana Petrisor Mirela Dnil | 2011 | World Journal of Radiology2011，3，7： | 24 |
| 3 | Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis:A comparative study显示文摘AIM:To assess the values of liver stiffness (LS) in pa-tients with hepatitis B virus (HBV) chronic hepatitis and to compare them with those in patients with hepatitis C virus (HCV) chronic hepatitis. METHODS: The study included 140 patients with HBV chronic hepatitis, and 317 patients with HCV chronic hepatitis, in which LS was measured (FibroScan-Echo-sens) and liver biopsy was performed in the same session (assessed according to the Metavir score). RESULTS:According to the Metavir score of the 140 HBV patients: one had F0,32 had F1, 67 had F2,33 had F3 and 7 had F4. Of the 317 HCV patients:5 had F0, 34 had F1, 146 had F2, 93 had F3 and 39 had F4. For the same severity of fibrosis, the mean values of LS in HBV patients were similar to those in HCV patients:F1,6.5±1.9 kPa vs 5.8±2.1 kPa (P=0.0889); F2,7.1±2 kPa vs 6.9±2.5 kPa (P = 0.3369); F3,9.1±3.6 kPa vs 9.9±5 kPa (P=0.7038); F4,19.8± 8.6 kPa vs 17.3±6.1 kPa (P=0.6574). A signif icant direct correlation between LS measurements and fibrosis was found in HCV patients (Spearman’s r=0.578, P<0.0001), as well as in HBV patients (r=0.408, P<0.0001). The correlation was more signif icant in HCV than in HBV patients (Fisher’s Z-test,Z= 2.210,P=0.0271). CONCLUSION:In our group, the mean values of LS in patients with chronic B hepatitis were similar to those in patients with chronic HCV hepatitis, for the same stage of f ibrosis. Also, LS was correlated with the severity of fibrosis both in HBV and HCV chronic hepatitis patients. | Ioan Sporea Roxana Sirli Alexandra Deleanu Adriana Tudora Alina Popescu Manuela Curescu Simona Bota | 2010 | World Journal of Gastroenterology2010，16，38： | 19 |
| 4 | Value of transient elastography for the prediction of variceal bleeding显示文摘AIM:To determine if liver stiffness(LS) measurements by means of transient elastography(TE) correlate with the presence of significant esophageal varices(EV) and if they can predict the occurrence of variceal bleeding.METHODS:We studied 1000 cases of liver cirrhosis divided into 2 groups:patients without EV or with grade 1 varices(647 cases) and patients with significant varices(grade 2 and 3 EV)(353 cases).We divided the group of 540 cases with EV into another 2 subgroups:without variceal hemorrhage(375 patients) and patients with a history of variceal bleeding(165 cases).We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve.RESULTS:The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV(26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa,P < 0.0001).Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV,with 83% sensitivity(95%CI:79.73%-85.93%) and 62% specificity(95% CI:57.15%-66.81%),with 76.2% positive predictive value(PPV)(95% CI:72.72%-79.43%) and 71.3% negative predictive value(NPV)(95% CI:66.37%-76.05%)(AUROC 0.7807,P < 0.0001).The mean LS values in the group with a history of variceal bleeding(165 patients) was statistically significantly higher than in the group with no bleeding history(375 patients):51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa,P < 0.0001).For a cut-off value of 50.7 kPa,LS had 53.33% sensitivity(95% CI:45.42%-61.13%) and 82.67% specificity(95% CI:78.45%-86.36%),with 82.71% PPV(95% CI:78.5%-86.4%) and 53.66% NPV(95% CI:45.72%-61.47%)(AUROC 0.7300,P < 0.0001) for the prediction of esophageal bleeding. | Ioan Sporea Iulia Ratiu Roxana Sirli Alina Popescu Simona Bota | 2011 | World Journal of Gastroenterology2011，17，17： | 14 |
| 5 | Why,who and how should perform liver biopsy in chronic liver diseases显示文摘Chronic viral hepatitis is a common disease in the general population.During chronic hepatitis,the prognosis and clinical management are highly dependent on the extent of liver fibrosis.The fibrosis evaluation can be performed by FibroTest(using serological markers),by Elastography or FibroScan(a noninvasive percutaneous technique using the elastic properties of the hepatic tissue) and by liver biopsy(LB),considered to be the 'gold standard'.Currently,there are three techniques for performing LB:percutaneous,transjugular and laparoscopic.The percutaneous LB can be performed blind,ultrasound(US) guided or US assisted.There are two main categories of specialists who perform LB:gastroenterologists(hepatologists) and radiologists,and the specialty of the individual who performs the LB determines if the LB is performed under ultrasound guidance or not.There are two types of biopsy needles used for LB:cutting needles(Tru-Cut,Vim-Silverman) and suction needles(Menghini,Klatzkin,Jamshidi).The rate of major complications after percutaneous LB ranges from 0.09% to 2.3%,but the echo-guided percutaneous liver biopsy is a safe method for the diagnosis of chronic diffuse hepatitis(cost-effective as compared to blind biopsy) and the rate of complications seems to be related to the experience of the physician and the type of the needle used(Menghini type needle seems to be safer).Maybe,in a few years we will use non-invasive markers of fibrosis,but at this time,most authorities in the field consider that the LB is useful and necessary for the evaluation of chronic hepatopathies,despite the fact that it is not a perfect test. | Ioan Sporea Alina Popescu Roxana Sirli | 2008 | World Journal of Gastroenterology2008，14，21： | 12 |
| 6 | Is it better to use two elastographic methods for liver fibrosis assessment?显示文摘AIM:To find out if by combining 2 ultrasound based elastographic methods:acoustic radiation force impulse(ARFI)elastography and transient elastography(TE),we can improve the prediction of fibrosis in patients with chronic hepatitis C.METHODS:Our study included 197 patients with chronic hepatitis C.In each patient,we performed,in the same session,liver stiffness(LS)measurements by means of TE and ARFI,respectively,and liver biopsy(LB),assessed according to the Metavir score.10 LS measurements were performed both by TE and ARFI;median values were calculated and expressed in kilopascals(kPa)and meters/second(m/s),respectively.Only TE and ARFI measurements with IQR<30%andSR≥60%were considered reliable.RESULTS:On LB 13(6.6%)patients had F0,32(16.2%) had F1,52(26.4%)had F2,47(23.9%)had F3,and 53(26.9%)had F4.A direct,strong correlation was found between TE measurements and fibrosis(r=0.741),between ARFI and fibrosis(r=0.730)and also between TE and ARFI(r=0.675).For predicting significant fibrosis(F≥2),for a cutoff of 6.7 kPa,TE had 77.5% sensitivity(Se)and 86.5%specificity(Sp)[area under the receiver operating characteristic curve(AUROC)0.87] and for a cutoff of 1.2 m/s,ARFI had 76.9%Se and 86.7%Sp(AUROC 0.84).For predicting cirrhosis(F=4),for a cutoff of 12.2 kPa,TE had 96.2%Se and 89.6% Sp(AUROC 0.97)and for a cutoff of 1.8 m/s,ARFI had 90.4%Se and 85.6%Sp(AUROC 0.91).When both elastographic methods were taken into consideration,for predicting significant fibrosis(F≥2),(TE≥6.7 kPa and ARFI≥1.2 m/s)we obtained 60.5%Se,93.3% Sp,96.8%positive predictive value(PPV),41.4%negative predictive value(NPV)and 68%accuracy,while for predicting cirrhosis(TE≥12.2 kPa and ARFI≥1.8 m/s) we obtained 84.9%Se,94.4%Sp,84.9%PPV,94.4% NPV and 91.8%accuracy.CONCLUSION:TE used in combination with ARFI is highly specific for predicting significant fibrosis;therefore when the two methods are concordant,liver biopsy can be avoided. | Ioan Sporea Roxana Sirli Alina Popescu Simona Bota Radu Badea Monica Lupsor Mircea Focsa Mirela Danila | 2011 | World Journal of Gastroenterology2011，17，33： | 11 |
| 7 | Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis显示文摘 | Simona Bota Harald Herkner Ioan Sporea Petra Salzl Roxana Sirli Adriana M. Neghina Markus Peck‐Radosavljevic | 2013 | Liver Int2013，，8： | 9 |
| 8 | Ultrasound-based elastography for the diagnosis of portal hypertension in cirrhotics显示文摘Progressive fibrosis is encountered in almost all chronicliver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks(inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis(serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasoundbased elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography(TE) and acoustic radiation force impulse(ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shearwave elastography, the Elast PQ technique and strain elastography all need to be evaluated as predictors of portal hypertension. | Roxana Sirli Ioan Sporea Alina Popescu Mirela Danila | 2015 | World Journal of Gastroenterology2015，21，41： | 6 |
| 9 | Severe adverse events during antiviral therapy in hepatitis C virus cirrhotic patients: A systematic review显示文摘AIM: To identify severe adverse events (SAEs) leading to treatment discontinuation that occur during antiviral therapy in hepatitis C virus (HCV)-infected cirrhotic patients. METHODS: We identified all the articles published prior to December 2011 in the PubMed, Medline, Lilacs, Scopus, Ovid, EMBASE, Cochrane and Medscape databases that presented these data in cirrhotic patients. These studies evaluated the rate of SAEs leading to discontinuation of standard care treatment: Pegylated interferon (PegIFN) alpha 2a (135-180 μg/wk) or PegIFN alpha 2b (1 or 1.5 μg/kg per week) and ribavirin (800-1200 mg/d). Patients with genotype 1 + 4 underwent treatment for 48 wk, whereas those with genotypes 2 + 3 were treated for 24 wk.RESULTS: We included 17 papers in this review, comprising of 1133 patients. Treatment was discontinued due to SAEs in 14.5% of the patients. The most common SAEs were: severe thrombocytopenia and/or neutropenia (23.2%), psychiatric disorders (15.5%), decompensation of liver cirrhosis (12.1%) and severe anemia (11.2%). The proportion of patients who needed to discontinue their therapy due to SAEs was significantly higher in patients with Child-Pugh class B and Cvs those with Child-Pugh class A: 22%vs 11.4% (P = 0.003). A similar discontinuation rate was found in cirrhotic patients treated with PegIFN alpha 2a and those treated with PegIFN alpha 2b, in combination with ribavirin: 14.2%vs 13.7% (P = 0.96). The overall sustained virological response rate in cirrhotic patients was 37% (95%CI: 33.5-43.1) but was significantly lower in patients with genotype 1 + 4 than in those with genotype 2 + 3: 20.5% (95%CI: 17.9-24.8) vs 56.5% (95%CI: 51.5-63.2), (P < 0.0001). CONCLUSION: Fourteen point five percent of HCV cirrhotic patients treated with PegIFN and ribavirin needed early discontinuation of therapy due to SAEs, the most common cause being hematological disorders. | Simona Bota Ioan Sporea Roxana Sirli Alina Popescu Adriana Maria Neghinǎ Mirela Dǎnilǎ Mihnea Strǎin | 2013 | World Journal of Hepatology2013，5，3： | 6 |
| 10 | Comparative Study Concerning the Value of Acoustic Radiation Force Impulse Elastography (ARFI) in Comparison with Transient Elastography (TE) for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis B and C显示文摘 | Ioan Sporea Roxana Sirli Simona Bota Alina Popescu Madalina Sendroiu Ana Jurchis | 2012 | Ultrasound in Medicine & Biology2012，，8： | 5 |
| 11 | Factors associated with the impossibility to obtain reliable liver stiffness measurements by means of Acoustic Radiation Force Impulse (ARFI) elastography—Analysis of a cohort of 1031 subjects显示文摘 | Simona Bota Ioan Sporea Roxana Sirli Alina Popescu Mirela Danila Ana Jurchis Oana Gradinaru-Tascau | 2013 | European Journal of Radiology2013，，： | 3 |
| 12 | Intra- and Interoperator Reproducibility of Acoustic Radiation Force Impulse (ARFI) Elastography–Preliminary Results显示文摘 | Simona Bota Ioan Sporea Roxana Sirli Alina Popescu Mirela Danila Dan Costachescu | 2012 | Ultrasound in Medicine & Biology2012，，7： | 3 |
| 13 | Acoustic Radiation Force Impulse Elastography for fibrosis evaluation in patients with chronic hepatitis C: An international multicenter study显示文摘 | Ioan Sporea Simona Bota Markus Peck-Radosavljevic Roxana Sirli Hironori Tanaka Hiroko Iijima Radu Badea Monica Lupsor Carmen Fierbinteanu-Braticevici Ana Petrisor Hidetsugu Saito Hirotoshi Ebinuma Mireen Friedrich-Rust Christoph Sarrazin Hirokazu Takahash | 2012 | European Journal of Radiology2012，，12： | 3 |
| 14 | Factors Which Influence the Accuracy of Acoustic Radiation Force Impulse (ARFI) Elastography for the Diagnosis of Liver Fibrosis in Patients With Chronic Hepatitis C显示文摘 | Simona Bota Ioan Sporea Roxana Sirli Alina Popescu Ana Jurchis | 2012 | Ultrasound in Medicine & Biology2012，，： | 2 |
| 15 | Value of acoustic radiation force impulse elastography for the assessment of ascites syndrome显示文摘AIM:To assess the feasibility of performing acoustic radiation force impulse(ARFI) elastography in patients with ascites and its predictive value for the cirrhotic or non-cirrhotic etiology of ascites.METHODS:Our study included 153 patients with ascites,mean age 58.8 ± 13.1 years.One hundred and fifteen(75.2%) patients had ascites in the context of cirrhosis,29(18.9%) had non-cirrhotic ascites(diagnosed by clinical,ultrasound,endoscopic and/or laparoscopic criteria) and in 9(5.9%) cases we could not establish the etiology of ascites.We performed 10 ARFI measurements and the median value was calculated and expressed in meters/second(m/s).Among the 29 patients with non-cirrhotic ascites were included:20 laparoscopically demonstrated peritoneal carcinomatosis with histological confirmation,7 acute pancreatitis with ascites which later resolved,and one case each of lymphatic ascites and ascites in the context of a liver abscess.In 11 of the 20 patients with peritoneal carcinomatosis,the liver structure was homogenous in the ultrasound examination and in 9 patients the ultrasound exam revealed liver metastases.RESULTS:We could not obtain valid ARFI measurements in 5 patients(3.2%).The mean liver stiffness measurements by means of ARFI were statistically significantly higher in patients with cirrhotic ascites than in those with non-cirrhotic ascites:3.04 ± 0.70 vs 1.45 ± 0.59 m/s(P < 0.001).For a cut-off value of 1.8 m/s for predicting cirrhosis(and ascites in the context of cirrhosis),as obtained in a previous study,ARFI had 98.1% sensitivity,86.2% specificity,96.4% positive predictive value,92.5% negative predictive value and 95.6% accuracy for predicting cirrhotic ascites.For a cut-off value of 1.9 m/s the accuracy was 94.9% and for a 2 m/s cut-off value it was 92.8%.CONCLUSION:ARFI elastography is feasible in most patients with ascites and has a very good predictive value for the cirrhotic or non-cirrhotic etiology of ascites. | Simona Bota Ioan Sporea Roxana Sirli Alina Popescu Mirela Dǎnilǎ Mǎdǎlina Sendroiu | 2011 | World Journal of Radiology2011，3，8： | 2 |
| 16 | Liver stiffness evaluated through transient elastography in patients chronicaly infected with HBV 显示文摘 | Sporea I Sirli R Deleanu A | 2009 | Hepatology2009，50，： | 1 |
| 17 | The mean values of liver stiffness assessed by Acoustic Radiation Force Impulse lastongraphy in normal subjects 显示文摘 | Popescu A Sporea I Sirli R | 2011 | Med Ultrason2011，13，1： | 1 |
| 18 | Contrast enhanced ultrasound for the diagnosis of liver hemangiomas in clinical practice显示文摘 | Sirli R Sporea I Popescu A | | 0，，02： | 1 |
| 19 | Contrast enhanced ultrasound (CEUS) in the evaluation of liver metastases显示文摘 | Danila M Popescu A Sirli R | 2010 | Med Ultrason2010，12，3： | 1 |
| 20 | Factors associated with the impos- sibility to obtain reliable liver stiffness measurements by means of Acoustic Radiation Force Impulse (ARFI) elastography-a- nalysis of a cohort of 1,031 subjects显示文摘 | Bota S Sporea I Sirli R | 2014 | Eur J Radiol2014，83，2： | 1 |
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