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Usefulness of acoustic radiation force impulse in liver fibrosis assessment after liver transplant
Veysel Özalper
,
Corresponding author
drzalper@gmail.com

Correspondence and reprint request:
, Coskun Ozturker**, Guner Sonmez***
* Hakkari Military Hospital, Department of Internal Medicine, Hakkari/Turkey
** Canakkale Military Hospital,Department of Radiology, Canakkale/Turkey
*** GATA Haydarpasa Training Hospital, Department of Radiology, Canakkale/Turkey
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Dear Editor&#44;</span><p id="p0005" class="elsevierStylePara elsevierViewall">We have read the article entitled <span class="elsevierStyleItalic">Usefulness of acoustic radiation force impulse and fibrotest in liver fibrosis assessment after liver transplant</span> by Bignulin&#44; <span class="elsevierStyleItalic">et al&#46;</span> with interest&#46;<a class="elsevierStyleCrossRef" href="#bib0005">1</a> They deduced that acoustic elastic radiation force impulse &#40;ARFI&#41; and Fibrotest were handy tools to stage the severity of fibrosis in patients with liver transplant&#46; We would like to thank the authors for their priceless contribution&#46; However&#44; we would like to report few concerns regarding this study from a methodological point of view&#46;</p><p id="p0010" class="elsevierStylePara elsevierViewall">First&#44; it is stated in the present study that the measurements of ARFI were performed in the right liver lobe through the intercostal space in the supine position&#46;<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Contrary to this research&#44; Uslu&#44; <span class="elsevierStyleItalic">et al&#46;</span> demonstrated that subcostal approach to the liver parenchyma was significantly superior to intercostal approach for the evaluation of stiffness&#46;<a class="elsevierStyleCrossRef" href="#bib0010">2</a> If the ARFI measurements had been performed through the subcostal space&#44; the pressure would have been transmitted better to liver parenchyma&#44; and this would have given better results than intercostal approach in terms of determining the elasticity of the liver&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">Second&#44; the length of the biopsy material was not mentioned in present study&#46; Bedossa&#44; <span class="elsevierStyleItalic">et al&#46;</span> demonstrated 40 mm long biopsy was considered an optimal specimen for accurate evaluation of liver fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Additionally&#44; the median number of the pieces of portal tracts was 10 in present study&#46; According to American Association of Study of Liver Disease guidelines&#44; an adequate number of portal tracts has been proposed to be &#62; 11&#46;<a class="elsevierStyleCrossRef" href="#bib0020">4</a> It would have been better&#44; if the authors had been mentioned these constitute limitations in the study&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">Third&#44; Trovato&#44; <span class="elsevierStyleItalic">et al&#46;</span> demonstrated that ARFI and transient elastography of the spleen is correlated with Ishak fibrosis staging&#44; and could be a possible additional tool for the diagnosis of liver fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0025">5</a> It would have been relevant&#44; if the authors had evaluated their patients according to spleen measurements of these techniques&#46;</p></span></span>"
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Article information
ISSN: 16652681
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