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Thorelius, Lars
Publications (10 of 12) Show all publications
Nasr, P., Hilliges, A., Thorelius, L., Kechagias, S. & Ekstedt, M. (2016). Contrast-enhanced ultrasonography could be a non-invasive method for differentiating none or mild from severe fibrosis in patients with biopsy proven non-alcoholic fatty liver disease. Scandinavian Journal of Gastroenterology, 51(9), 1126-1132
Open this publication in new window or tab >>Contrast-enhanced ultrasonography could be a non-invasive method for differentiating none or mild from severe fibrosis in patients with biopsy proven non-alcoholic fatty liver disease
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2016 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, no 9, p. 1126-1132Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The gold standard for diagnosing fibrosis stage in non-alcoholic fatty liver disease (NAFLD) is liver biopsy. The aim of this study was to determine whether contrast-enhanced ultrasonography (CEUS) with transit time measurements could be a non-invasive alternative for differentiating none or mild from severe fibrosis in NAFLD patients. Various serum markers and clinical variables were also evaluated.

MATERIALS AND METHODS: Fifty-eight patients with NAFLD underwent CEUS prior to liver biopsy. All patients were also evaluated according to the Göteborg University Cirrhosis Index (GUCI), the AST-Platelet Ratio Index (APRI), the NAFLD fibrosis score, and the FIB-4 and BARD score.

RESULTS: The hepatic vein arrival time (HV) was shorter in patients with severe fibrosis (25.9 ± 4.8 vs 29.5 ± 4.7 s, p = 0.023), and the difference between the hepatic and portal vein (ΔHV-PV) was shorter (2.3 ± 2.8 vs 6.4 ± 2.8 s, p < 0.0001) while the difference in arrival time between the portal vein and hepatic artery (ΔPV-HA) arrival time was significantly longer (6.0 ± 2.2 vs 3.6 ± 1.6 s, p < 0.0001). The area under receiver operating characteristics curve values for HV, ΔHV-PV and ΔPV-HA to separate none or mild from severe fibrosis was 0.71, 0.83 and 0.84, respectively. The corresponding figures for GUCI, APRI, NAFLD fibrosis score, FIB-4 and BARD score were 0.93, 0.92, 0.86, 0.90 and 0.77, respectively.

CONCLUSIONS: CEUS and non-invasive scoring systems could exclude severe fibrosis in NAFLD patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Contrast-enhanced ultrasonography, fibrosis, fibrosis scores, non-alcoholic fatty liver disease
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-129954 (URN)10.3109/00365521.2016.1172336 (DOI)000381406800018 ()27161854 (PubMedID)
Note

Funding agencies: Research Council of Southeast Sweden [F2004-303]; ALF Grants, Region Ostergotland

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2025-02-11Bibliographically approved
Ekstedt, M., Franzén, L. E., Mathiesen, U. L., Thorelius, L., Holmqvist, M., Bodemar, G. & Kechagias, S. (2006). Long-term follow-up of patients with NAFLD and elevated liver enzymes.. Hepatology, 44(4), 865-873
Open this publication in new window or tab >>Long-term follow-up of patients with NAFLD and elevated liver enzymes.
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2006 (English)In: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 44, no 4, p. 865-873Article in journal (Refereed) Published
Abstract [en]

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated liver enzymes in patients of developed countries. We determined the long-term clinical and histological courses of such patients. In a cohort study, 129 consecutively enrolled patients diagnosed with biopsy-proven NAFLD were reevaluated. Survival and causes of death were compared with a matched reference population. Living NAFLD patients were offered repeat liver biopsy and clinical and biochemical investigation. Mean follow-up (SD) was 13.7 (1.3) years. Mortality was not increased in patients with steatosis. Survival of patients with nonalcoholic steatohepatitis (NASH) was reduced (P = .01). These subjects more often died from cardiovascular (P = .04) and liver-related (P = .04) causes. Seven patients (5.4%) developed end-stage liver disease, including 3 patients with hepatocellular carcinoma. The absence of periportal fibrosis at baseline had a negative predictive value of 100% in predicting liver-related complications. At follow-up, 69 of 88 patients had diabetes or impaired glucose tolerance. Progression of liver fibrosis occurred in 41%. These subjects more often had a weight gain exceeding 5 kg (P = .02), they were more insulin resistant (P = .04), and they exhibited more pronounced hepatic fatty infiltration (P = .03) at follow-up. In conclusion, NAFLD with elevated liver enzymes is associated with a clinically significant risk of developing end-stage liver disease. Survival is lower in patients with NASH. Most NAFLD patients will develop diabetes or impaired glucose tolerance in the long term. Progression of liver fibrosis is associated with more pronounced insulin resistance and significant weight gain.

Keywords
Liver, quantification, steatosis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17323 (URN)10.1002/hep.21327 (DOI)17006923 (PubMedID)
Available from: 2009-03-18 Created: 2009-03-18 Last updated: 2020-08-14Bibliographically approved
Escobar Kvitting, J.-P., Sandström, P., Thorelius, L., Kullman, E., Borch, K. & Svanvik, J. (2006). Radiofrequency ablation of a liver metastasis complicated by extensive liver necrosis and sepsis caused by gas gangrene. Surgery, 139(1), 123-125
Open this publication in new window or tab >>Radiofrequency ablation of a liver metastasis complicated by extensive liver necrosis and sepsis caused by gas gangrene
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2006 (English)In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 139, no 1, p. 123-125Article in journal (Refereed) Published
Abstract [en]

[No abstract available]

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35718 (URN)10.1016/j.surg.2005.06.019 (DOI)28289 (Local ID)28289 (Archive number)28289 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Thorelius, L. (2005). Characterization of liver metastases in cancer patients. In: Contrast-Enhanced Ultrasound in General Imaging: (pp. 30-34). Krakow, Poland: Springer
Open this publication in new window or tab >>Characterization of liver metastases in cancer patients
2005 (English)In: Contrast-Enhanced Ultrasound in General Imaging, Krakow, Poland: Springer , 2005, p. 30-34Chapter in book (Other academic)
Place, publisher, year, edition, pages
Krakow, Poland: Springer, 2005
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-30465 (URN)16036 (Local ID)88-470-0422-5 (ISBN)16036 (Archive number)16036 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-10-03Bibliographically approved
Thorelius, L. (2005). Contrast-enhanced ultrasonography beyond focal liver lesions. In: Contrast-Enhanced Ultrasound in General Imagning: (pp. 58-63). Krakow, Poland: Springer
Open this publication in new window or tab >>Contrast-enhanced ultrasonography beyond focal liver lesions
2005 (English)In: Contrast-Enhanced Ultrasound in General Imagning, Krakow, Poland: Springer , 2005, p. 58-63Chapter in book (Other academic)
Place, publisher, year, edition, pages
Krakow, Poland: Springer, 2005
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-30466 (URN)16037 (Local ID)88-470-0422-5 (ISBN)16037 (Archive number)16037 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-10-03
Thorelius, L. (2005). Usefulness of Contrast-Enhanced Ultrasound in Characterization of Pancreatic and Renal Masses. In: Contrast-Enhanced Ultrasound in Clinical Practice (pp. 25-35). Milan: Springer
Open this publication in new window or tab >>Usefulness of Contrast-Enhanced Ultrasound in Characterization of Pancreatic and Renal Masses
2005 (English)In: Contrast-Enhanced Ultrasound in Clinical Practice, Milan: Springer , 2005, p. 25-35Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Milan: Springer, 2005
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-24393 (URN)6487 (Local ID)88-470-0304-0 (ISBN)6487 (Archive number)6487 (OAI)
Available from: 2009-10-07 Created: 2009-10-07
Thorelius, L. (2004). Contrast-enhanced ultrasound for extrahepatic lesions: Preliminary experience. European Journal of Radiology, 51(SUPPL.)
Open this publication in new window or tab >>Contrast-enhanced ultrasound for extrahepatic lesions: Preliminary experience
2004 (English)In: European Journal of Radiology, ISSN 0720-048X, E-ISSN 1872-7727, Vol. 51, no SUPPL.Article in journal (Refereed) Published
Abstract [en]

Ultrasound imaging (US) is a convenient, inexpensive and non-invasive investigation. Its use is limited by low sensitivity in the detection of a number of parenchymal lesions, especially those produced by trauma, such as infarctions. Contrast enhancement with SonoVue® improves the sensitivity of ultrasound in the detection and characterization of focal liver lesions to such an extent, that it may replace computed tomography (CT) and magnetic resonance imaging (MRI). Preliminary experience suggests that SonoVue-enhanced sonography may be useful in the detection of lesions in which blood flow is severely reduced as compared to surrounding parenchyma, such as infarctions, lacerations, hematomas, necrotic tissue and non-vascular cysts, especially in the spleen, kidney and pancreas. This technique can also rule out occlusion of the superior mesenteric, splenic and portal veins, and dilation of the biliary tree. Clinical trials comparing contrast-enhanced sonography with contrast-enhanced computed tomography are warranted to establish the role of this inexpensive and non-invasive technique in the routine work-up of patients with abdominal trauma or presenting with sudden flank pain. © 2004 Published by Elsevier Ireland Ltd.

Keywords
Abdominal trauma, Kidney, Pancreas, Parenchymal lesions, Spleen, Ultrasound contrast agents
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-45717 (URN)10.1016/j.ejrad.2004.03.028 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Thorelius, L. (2004). Contrast-enhanced ultrasound in trauma. European Radiology, Supplement, 14(ISSUENR. 8)
Open this publication in new window or tab >>Contrast-enhanced ultrasound in trauma
2004 (English)In: European Radiology, Supplement, ISSN 1613-3749, Vol. 14, no ISSUENR. 8Article, review/survey (Refereed) Published
Abstract [en]

When attempting a literature review on contrast-enhanced ultrasound (CEUS) in trauma, very few articles are found. There are a large number of papers dealing with FAST (focused assessment with sonography in trauma) which, in practice, is the definition for detection of free fluid in the abdomen, but there are papers covering assessment of parenchymal damage with nonenhanced ultrasound. This review focuses on direct assessment of parenchymal damage in blunt abdominal trauma, and includes papers on non-enhanced ultrasound to give a historical background to scientific approaches to ultrasound diagnosis of parenchymal injury. A report on our local experience of CEUS in trauma has also been included. © Springer-Verlag 2005.

Keywords
Contrast agents, Microbubbles, Trauma, Ultrasound
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-45590 (URN)10.1007/s10406-004-0078-1 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2011-01-12
Thorelius, L. (2004). Contrast-enhanced ultrasound in trauma. European Radiology, 14, suppl 8, 43-52
Open this publication in new window or tab >>Contrast-enhanced ultrasound in trauma
2004 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 14, suppl 8, p. 43-52Article in journal (Refereed) Published
Keywords
ultrasound, trauma, contrast agents, microbubbles
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31992 (URN)17842 (Local ID)17842 (Archive number)17842 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Thorelius, L. (2003). Contrast-enhanced ultrasound: beyond the liver.. European Radiology, 13, 91-108
Open this publication in new window or tab >>Contrast-enhanced ultrasound: beyond the liver.
2003 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 13, p. 91-108Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27176 (URN)10.1007/s00330-003-0014-0 (DOI)11825 (Local ID)11825 (Archive number)11825 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
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