title: Ultrasound evaluation of liver disease in cystic fibrosis as part of an annual assessment clinic: a 9-year review.
abstract: OBJECTIVE
  To review 9 years of annual assessment data in cystic fibrosis (CF) and evaluate the frequency of hepatobiliary abnormalities and the correlation between ultrasound and biochemical findings.
  
  
  METHODS
  Over a 9-year period (1990-99), 168 children (age range 1-18 years) with CF have undergone an annual assessment which has included clinical, biochemical and ultrasonographic evaluation of the hepatobiliary system. We have retrospectively reviewed the sequential ultrasound reports and correlated them with the contemporaneous biochemical results.
  
  
  RESULTS
  A total of 725 ultrasound examinations were performed over the review period. Sixty patients had at least one examination showing an abnormality of liver echo texture and in 39 patients this was a persisting finding. Seven patients (4.2%) developed frank cirrhotic change on ultrasound criteria, while 15 patients (8.9%) had evidence of persistent splenomegaly. Gall-bladder calculi were present in 4.8%. In 176 examinations (24%) there was disparity between the ultrasound findings and aspartate aminotransferase (AST) levels. In 3.0% of cases (five patients) there were persisting abnormalities of liver echo texture and persisting splenomegaly with a normal range AST value.
  
  
  CONCLUSIONS
  No perfect method of assessing hepatobiliary involvement in CF is currently available. Ultrasonographic and biochemical assessment may reflect different aspects of disease progression. Routine use of ultrasound in annual assessment allows identification of a minority of patients with liver changes but with normal biochemistry.
authors.affiliation: Department of Radiology, John Radcliffe Hospital, Oxford, U.K. dr.stuartwilliams@btinternet.com
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Williams
authors.forename: Robin
authors.initials: R
authors.lastname: Goodman
authors.forename: Anne
authors.initials: A
authors.lastname: Thomson
authors.forename: Kieran
authors.initials: K
authors.lastname: McHugh
authors.forename: David R M
authors.initials: DR
authors.lastname: Lindsell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D013163:Splenomegaly / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases