Relevance of reduced portal flow velocity, low platelet count and enlarged spleen diameter in the non-invasive diagnosis of compensated liver cirrhosis.
OBJECTIVE
The aim of this prospective study was to identify the combination of parameters best able to predict the diagnosis of compensated cirrhosis.


METHODS
One hundred and fourteen patients with suspected chronic compensated liver disease were divided, on the basis of bioptical findings, into two groups: group A, without cirrhosis (n = 58) and group B, with cirrhosis (n = 56). A number of biochemical parameters, the extent of oesophageal varices, spleen size, portal vein diameter and maximum and mean portal flow velocity measured by duplex-Doppler ultrasonography were taken into account in a binary forward-stepwise multiple logistic regression analysis.


RESULTS
Only three variables were present in the final regression equation, maximum portal flow velocity affording the highest correlation with the histological diagnosis of cirrhosis (p = 0.0007), with an overall predictive value of 87.7%. When associated with the bipolar diameter of the spleen (p = 0.0169) and the number of platelets (p = 0.0487), the predictive value rose to 94.7%. If all three parameters were normal, a non-cirrhotic liver disease was most likely (96% probability); if two or three of the parameters were abnormal, liver cirrhosis was almost certain (98% probability); if only one parameter was abnormal, the clinical diagnosis was uncertain.


CONCLUSIONS
This study emphasizes the usefulness of duplex Doppler ultrasonography in the non-invasive diagnosis of compensated cirrhosis.
Cioni
G
G
Clinica Medicia III, University of Modena, Italy.
Tincani
E
E
D'Alimonte
P
P
Cristani
A
A
Ventura
P
P
Abbati
G
G
Vignoli
A
A
Romagnoli
R
R
Ventura
E
E
D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D013154:Spleen / Q000000981:diagnostic imaging*; D014463:Ultrasonography