title: Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy.
abstract: OBJECTIVE
  To evaluate hepatic fibrosis and tumor diagnosis preoperatively, we investigated the elasticity calculated by the new parameter of ultrasonography, acoustic radiation force impulse (ARFI).
  
  
  METHODS
  We examined ARFI of the non-tumorous right and left lateral liver and in the tumor by push pulse of probe in 95 patients with hepatic malignancies undergoing hepatectomy. Measurement of ARFI as hepatic stiffness was indicated as the Vs (m/s).
  
  
  RESULTS
  Measuring the Vs in the non-tumor region was achieved in the right liver in 99% and at the left lateral liver in 94%. The Vs in the right liver was significantly lower than in the left lateral liver, and the Vs of the liver tumor was significantly higher than in the non-tumorous liver. The Vs in the right and left lateral liver was correlated with the platelet count, aspartate aminotransferase, fibrotic indices and indocyanine green test. The Vs in the right liver was significantly correlated with the fibrotic marker or index. The Vs of liver cirrhosis and histological stage 4 in the right and left liver was significantly the highest compared to the others. The Vs in the right liver showed a high area under the receiver-operator curve value predicting histological fibrosis. The Vs in the right was significantly correlated with blood loss and postoperative complications, particularly uncontrolled ascites.
  
  
  CONCLUSIONS
  Non-invasive ARFI imaging elastography is useful in evaluating impaired liver function or in the differential diagnosis of liver malignancies, highly hepatic fibrosis and in predicting posthepatectomy morbidity.
authors: Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Atsushi
authors: A
authors: Nanashima
authors: Ayami
authors: A
authors: Sakamoto
authors: Ichiro
authors: I
authors: Sakamoto
authors: Hideyuki
authors: H
authors: Hayashi
authors: Takafumi
authors: T
authors: Abo
authors: Kouki
authors: K
authors: Wakata
authors: Goushi
authors: G
authors: Murakami
authors: Junichi
authors: J
authors: Arai
authors: Hideo
authors: H
authors: Wada
authors: Katsunori
authors: K
authors: Takagi
authors: Hiroaki
authors: H
authors: Takeshita
authors: Shigekazu
authors: S
authors: Hidaka
authors: Kazuo
authors: K
authors: To
authors: Takeshi
authors: T
authors: Nagayasu
keywords: acoustic radiation force impulse; hepatectomy; hepatic fibrosis; liver tumor; morbidity; ultrasonography