Hepatopulmonary syndrome diagnostic study of choice: Difference between revisions
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The following findings are confirmatory for hepatopulmonary syndrome: (discussed in details) | The following findings are confirmatory for hepatopulmonary syndrome: (discussed in details) | ||
* Presence of bubbles on the left heart in contrast-enhanced transthoracic echocardiography with agitated saline | * Presence of bubbles on the left heart in contrast-enhanced transthoracic echocardiography with agitated saline | ||
* Presence of radioactivity on the left heart in Technetium 99m-labeled macroaggregated albumin scanning | * Presence of radioactivity on the left heart in Technetium 99m-labeled macroaggregated albumin scanning<ref name="pmid9453490">Abrams GA, Nanda NC, Dubovsky EV, Krowka MJ, Fallon MB (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9453490 Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach.] ''Gastroenterology'' 114 (2):305-10. PMID: [https://pubmed.gov/9453490 9453490]</ref> | ||
*Diffusion defect in atrial blood gas analysis particularly studying | *Diffusion defect in atrial blood gas analysis particularly studying | ||
*Abnormal liver function studies | *Abnormal liver function studies | ||
Revision as of 14:11, 5 September 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
There is no single diagnostic study of choice for the diagnosis of hepatopulmonary syndrome, but hepatopulmonary syndrome can be diagnosed based on history of liver disease, atrial blood gas analysis (widened alveolar-arterial oxygen gradient measurement); and evidences of intra-pulmonary vascular dilation or arterio-venous communications that result in a right-to-left intrapulmonary shunt.
Diagnostic Study of Choice
Study of choice:
There is no single diagnostic study of choice for the diagnosis of hepatopulmonary syndrome, but hepatopulmonary syndrome can be diagnosed based on history of liver disease, atrial blood gas analysis (widened alveolar-arterial oxygen gradient measurement); and evidences of intra-pulmonary vascular dilation or arterio-venous communications that result in a right-to-left intrapulmonary shunt.
Investigations:
- Among the patients who present with clinical signs of hepatopulmonary syndrome, the contrast-enhanced transthoracic echocardiography with agitated saline is the most specific test for the diagnosis.
- Among the patients who present with clinical signs of hepatopulmonary syndrome, the atrial blood gas analysis is the most sensitive test for diagnosis.
Diagnostic results
The following findings are confirmatory for hepatopulmonary syndrome: (discussed in details)
- Presence of bubbles on the left heart in contrast-enhanced transthoracic echocardiography with agitated saline
- Presence of radioactivity on the left heart in Technetium 99m-labeled macroaggregated albumin scanning[1]
- Diffusion defect in atrial blood gas analysis particularly studying
- Abnormal liver function studies
- Abnormal pulmonary function test
References
- ↑ Abrams GA, Nanda NC, Dubovsky EV, Krowka MJ, Fallon MB (1998) Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology 114 (2):305-10. PMID: 9453490