title: Comparison between Doppler ultrasonography and multiphase multidetector-row computed tomography in the detection of liver involvement in Rendu-Osler disease: An analysis of 62 patients.
abstract: OBJECTIVE
  To evaluate the agreement between the Buscarini criteria on ultrasound (US) and multiphase contrast-enhanced multidetector-row computed tomography (MDCT) in the diagnosis and staging of liver involvement in hereditary hemorrhagic telangiectasia (HHT) (i.e., Rendu-Osler disease). To evaluate the role of variations in hepatic artery anatomy in the production of disagreement between these two imaging techniques.
  
  
  METHODS
  This single center retrospective study included 62 patients with confirmed or suspected HHT. Each patient underwent Doppler US analyzed according to the Buscarini criteria and arterial and portal phase MDCT on the same day or one day apart. Liver involvement was classified as absent, slight, moderate or severe for each examination. Agreement was evaluated by the kappa and Bhapkar tests. Variations in hepatic arterial anatomy was analyzed by MDCT based on the Michel's classification and analysis of agreement and disagreement was performed using the Chi(2) test.
  
  
  RESULTS
  Significant disagreement was identified between the two tests in 29 patients with κ=0.376 and a Bhapkar critical probability of P=0.0053. Staging of liver involvement was significantly more severe with MDCT in case of disagreement. A variant hepatic artery anatomy was identified in 12 patients with agreement and 7 patients with disagreement, but the difference was not significant (Chi(2)=0.297).
  
  
  CONCLUSIONS
  The results of our study confirm the importance of associating contrast-enhanced MDCT with Doppler US in the evaluation of liver involvement in patients with HHT.
authors.affiliation: Service du groupement d'imagerie médicale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France. Electronic address: ijag@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Cavel
authors.affiliation: Service du groupement d'imagerie médicale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Bleuzen
authors.affiliation: Service du groupement d'imagerie médicale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors.forename: P
authors.initials: P
authors.lastname: Bertrand
authors.affiliation: Service du groupement d'imagerie médicale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors.forename: F
authors.initials: F
authors.lastname: Patat
authors.affiliation: Service du groupement d'imagerie médicale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Cottier
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications*; D018615:Ultrasonography, Doppler, Color
keywords: Computed tomography; Doppler US; Hereditary hemorrhagic telangiectasia; Liver; Rendu-Osler Disease