Abstracts S21

Scientific Papers – Digital Presentation

1 - Abdomen Ultrasound

PA.01.011

Focal Nodular Hyperplasia During Acute Abdomen Ultrasound

Diagnosis and Correlation With Computed Tomography and

Magnetic Resonance During an Acute Abdomen

A. C. Ferreira, F. S. Costa, A. J. Reis Neto, K. B. Alcantara, J. F. Jord~ao,

R. C. S. Faria

Instituto De Diagnostico Por Imagem, Hospital Santa Casa Ribeirao

Preto, SP, Brasil

Brief Description of the Purpose of the Report:We describe a case of

acute abdomen diagnosed as focal nodular hyperplasia (FNH) during

our shift, correlating the imaging methods.

Medical History: Female patient, caucasian, 34 years old, was admitted

with a history of colic in the right subcostal area 2 days ago, on physical

examination the patient was found to be in a good state, with no fever,

nausea, vomiting, jaundice and trauma.

Diagnosis: Focal nodular hyperplasia.

Discussion and Summary of the Case: The ultrasound showed iso-

echogenic injury of partially defined interface, color Doppler identified

vascularity inside, compatible with possible focal nodular hyperplasia

with probable perinodular and intranodular bleeding. Computed tomog-

raphy (CT) and magnetic resonance imaging (MRI) were also per-

formed to confirm diagnosis but with no presence of intralesional

bleeding. Although the etiology of FNH is still controversial, probably

comes from a vascular malformation which leads to a local increase

in blood flow. Complications such as abdominal discomfort, intratu-

moral hemorrhage and intraperitoneal rupture are rare and may require

surgery. Despite our patient presenting abdominal pain, intranodular

bleeding was discarded by CT and MRI, conservative treatment being

chosen with regular image control.

PD.01.001

Comparison of Abdominal Ultrasonographic Findings With

Endoscopic Ultrasonographic Findings of Solid Pseudopapillary

Tumor of Pancreas

J. J. Chung, W. S. Jung, J. S. Yu, J. H. Kim, E. S. Cho

Department of Radiology, Gangnam Severance Hospital, Yonsei

University College of Medicine, Seoul, Korea

Brief Description of the Purpose of the Study: To compare abdominal

ultrasonographic (AU) findings with endoscopic ultrasonographic

(EUS) findings of solid pseudopapillary tumor (SPT) of pancreas.

Methods:Thirteen patients (M:F53:10; mean age, 36 years) with surgi-

cally proven SPT were included, who underwent both preoperative AU

and EUS. Ultrasonographic findings of 2 modalities were compared ac-

cording to internal echogenicity, solid or cystic portion, internal septum,

calcification, fluid-fluid level, demarcation and main pancreatic duct

dilatation.

Main Results: Among 13 cases, 8 cases showed hypoechogenicity on

both AU and EUS. Remaining 5 cases showed different echogenicity

on both modalities; hypoechogenicity (n53) and isoechogenicity

(n52) on AU, hyperechogenicity (n52), unremarkable echogenicity

due to dense rim calcifications (n52), isoechogenicity (n51) on EUS.

In two cases with rim calcifications, evaluation of the internal content

was more difficult on EUS, compared to AU. Two cases with central

punctate calcifications and 1 case with peripheral calcifications were

seen. Internal fluid-fluid level was noted in 2 cases on both modalities.

All cases showed good demarcation without pancreatic ductal dilatation

or internal septum.

Importance of the Conclusions: EUS was somewhat superior to AU in

the evaluation of internal echo texture (solid or cystic) of pancreatic SPT.

However, AU was superior to evaluate the larger size tumor and tumors

with dense rim calcifications.

PD.01.002

Evaluation of SWV Measured by ARFI Technology in Hepatic

Fibrosis

Y. E. Zhen, B. A. O. Zhongtao, G. U. Lijuan

Department of Ultrasound,the First Affiliated Hospital of Fujian

Medical University, China

Brief Description of the Purpose of the Study: To explore the applica-

tion value of the liver shear wave velocity (SWV) measured by acoustic

radiation force impulse (ARFI) technology in hepatic fibrosis caused by

chronic hepatitis B.

Methods: The use of ACUSON S2000 color ultrasound system. The

measurement of liver SWV in left lateral decubitus were performed

on patients with chronic hepatitis B (n5210) and normal volunteers

(n520) and the position were as liver biopsy as possible. All patients

with chronic hepatitis B were accepted liver biopsy under ultrasound-

guided.

Main Results: SWV values in the cases with chronic hepatitis B

increased gradually with the growing degree of hepatic fibrosis. SWV

values among each fibrosis groups were remarkably different(P50.000).

Using the cutoff values of 1.43m/s, 1.78m/s, 2.15m/s and 2.45m/s for

diagnosis of $S1,$S2,$S3 and 5 S4, the corresponding areas under

receiver operating characteristic curves (AUROC) were 0.826, 0.829,

0.845 and 0.880 respectively. The sensitivity was 85.3%, 90.6%, 87.1%

and 89.1%; the specificity was 87.5%, 90.1%, 82.8% and 87.4%; the

accuracy was 89.4%, 84.6%, 88.1% and 83.2% respectively. Under-

taking Spearman double variables correlated analysis between the

SWV values and the parameters of fibrosis grade, inflammation grade

and steatosis grade, the analyses shown were statistically significant

between SWV value and fibrosis grade,SWV value and inflammation

grade. The correlation coefficient were 0.713 (p 5 0.000)and 0.496

(p 5 0.001),but there was no obvious correlation between SWV value

and steatosis grade in our study, the correlation coefficient was 0.145

(p 5 0.368). Multiple linear regression showed that it had correlation

relationship between SWV values and fibrosis grade (p 5 0.000), the

standard regression coefficient was 0.664,but there was no obvious

correlation relationship between SWV values and inflammation grade,

SWV values and steatosis grade (P.0.05).

Importance of the Conclusions: SWV measurement can directly

reflect the elasticity modulus of liver, and the value can reflect the differ-

ence of hardness among every S stage. It can also identify hepatic

fibrosis degree in a effective, convenient and non-invasive way. SWV

measurement can be recommended as a new and to judge hepatic

fibrosis degree.

PD.01.003

Can Ultrasound Give Valuable Clues in the Diagnosis of Bile

Leakage?

C. Tana, P. D’Alessandro, M. Tana, A. Mezzetti, C. Schiavone

Departmental Unit of Internistic Ultrasound, Department of Medicine

and Science of Excellence on Aging, -G. D’Annunzio- University, Chieti,

Italy

Brief Description of the Purpose of the Report: The purpose of our

case report was to demostrate that ultrasound can reveal the presence

of valuable clues to diagnose a biloma.