Ultrasonographic diagnosis of acute alcoholic hepatitis 'pseudoparallel channel sign' of intrahepatic artery dilatation.
BACKGROUND
In an ultrasound pilot study of acute alcoholic hepatitis (AAH), parallel tubular structures within the liver subsegments were observed. Pulse-Doppler flowmetry revealed that these structures were formed by a dilated hepatic arterial branch and an adjacent portal venous branch. This finding was termed the "pseudoparallel channel sign" (PPCS). The aims of this study were to assess the significance of this sign and show the characteristic ultrasound findings of AAH.


METHODS
PPCS was specifically searched for on ultrasonography by two physician operators in consecutive patients (77 AAH, 119 other alcoholic liver disease, 49 nonalcoholic liver disease, and 15 healthy patients).


RESULTS
PPCS was observed in 90% of patients with AAH and in 23% of patients with other alcoholic liver disease. This sign was not detected in nonalcoholic liver disease or healthy patients. Biopsy specimens were available in 100 patients, 51 of whom were patients with alcoholism. In those 51 patients, PPCS gave a sensitivity of 82%, a specificity of 87%, and an accuracy of 84% in diagnosing AAH. Patients with criteria of AAH had more segments involved with PPCS than patients without.


CONCLUSIONS
PPCS may be an important diagnostic finding in AAH.
Sumino
Y
Y
Division of Gastrointestinal and Liver Diseases, School of Medicine, University of Southern California, Los Angeles.
Kravetz
D
D
Kanel
G C
GC
McHutchison
J G
JG
Reynolds
T B
TB
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006519:Hepatitis, Alcoholic / Q000000981:diagnostic imaging*; D006801:Humans; D008102:Liver Circulation; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography