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您的检索式：作者名="Brian Strife"
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| 1 | Use of doppler ultrasound to predict need for transjugular intrahepatic portosystemic shunt revision显示文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is used to treat complications of portal hypertension,such as ascites and variceal bleeding(VB).While liver doppler ultrasound(DUS)is used to assess TIPS patency,trans-shunt venography(TSV)is the gold standard.AIM To determine the accuracy of DUS to assess TIPS dysfunction and for need for revision.METHODS Retrospective review of patients referred for TIPS revision from 2008-2021.Demographics,DUS parameters at baseline and at the DUS preceding TIPS revision,TSV data were collected.Receiver operating characteristics curves,sensitivity,specificity,performance for doppler to predict need for revision were performed.Univariate and multivariate analyses were used to predict clinical factors associated with need for TIPS revision.RESULTS The cohort consisted of 89 patients with cirrhosis(64%men,76%white,31%alcohol as etiology);median age 59 years.Indication for initial TIPS were VB(41%),refractory ascites(51%),and other(8%).TIPS was revised in 44%.On univariate analysis,factors associated with need for TIPS revision were male(P=0.03),initial indication for TIPS(P=0.05)and indication for revision(P=0.01).Revision of TIPS was associated with lower mortality(26%vs 46%)and significantly lower rates of transplant(13%vs 24%;P=0.1).In predicting need for TIPS revision,DUS has a 40%sensitivity,45%specificity,PPV 78%,and NPV 14%.The most accurate location for shunt velocity measure was distal velocity(Area under the curve:0.79;P=0.0007).CONCLUSION DUS has poor overall sensitivity and specificity in predicting need for TIPS revision.Non-invasive methods of predicting TIPS dysfunction are needed since those needing TIPS revision had better survival. | Nikki Duong Marcus Healey Kunal Patel Brian J Strife Richard K Sterling | 2022 | World Journal of Hepatology2022，14，6： | 0 |
| 2 | Liver cancer understaging in liver transplantation in the current era of radiologic imaging and newer generation locoregional therapies显示文摘Background:Discordance in hepatocellular carcinoma(HCC)staging between pre-transplant imaging and explant pathology is associated with an increased risk of recurrence and death.Our aim was to evaluate variables that predicted concordance/discordance in the era of new generation locoregional therapies(LRT)and improved radiologic technology in diagnosis.Methods:A single-center retrospective study was performed on patients who received a liver transplant for HCC between 2008-2019.Pre-and post-LT variables,including type of LRT,downstaging(DS),transplant time period,and radiologic response to LRT,were analyzed for concordance/discordance.Kaplan-Meier analysis was used to assess post-LT survival.Results:Of 146 patients transplanted within Milan Criteria(MC),discordance rates(understaged)were 45%.Discordance was associated with≥3 HCC lesions at diagnosis but not newer generation LRT(transarterial radioembolization/stereotactic body radiation therapy),traditional LRT or combination.No differences in discordance were seen between transplant periods(2008-2013 vs.2014-2019),but those within MC in the earlier period had higher concordance rates.A trend was observed between DS and discordance.Conclusion:HCC stage discordance remains common and poorly predictable.Discordance was associated with three or more HCC lesions at the time of diagnosis.Patients within MC transplanted between 2008-2013 was associated with concordance,while a trend was noted between DS and discordance.No other pre-or post-LT variables predicted discordance/concordance.Discordance was associated with decreased survival. | Hannah M.Lee Donna McClish Binu V.John Sarah Winks Ryan Clayton Somaya Albhaisi Allawy Allawy Samarth Patel Emma C.Fields Scott Matherly Brian Strife Chandra Bhati Amit Sharma Richard K.Sterling | 2022 | Hepatoma Research2022，8，1： | 0 |
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