title: Coarse nodular US pattern in hepatic cirrhosis: risk for hepatocellular carcinoma.
abstract: OBJECTIVE
  To determine the prevalence of the coarse nodular ultrasonographic (US) pattern and its prognostic importance in terms of hepatocellular carcinoma (HCC) risk in hepatic cirrhosis caused by hepatitis B virus (HBV); HBV with hepatitis D virus (HDV), formerly known as hepatitis delta virus; hepatitis C virus (HCV); and alcoholic cirrhosis (ALC) or primary biliary disease (primary biliary cirrhosis [PBC]).
  
  
  METHODS
  Four hundred two cases of hepatic cirrhosis caused by HBV (94 patients), HDV (100 patients), HCV (100 patients), ALC (63 patients), or PBC (45 patients) were retrospectively reviewed to identify the US pattern present at diagnosis and its possible association with the cause of the disease and subsequent development of HCC during a mean follow-up of 43.9 months +/- 29.9 (SD). Data were analyzed with the chi2, Fisher exact, and log-rank tests and with the Kaplan-Meier method (all two-tailed).
  
  
  RESULTS
  The coarse nodular pattern was found in a significantly higher percentage of patients with HDV-related cirrhosis (51%) compared with those with HBV (9%), HCV (9%), ALC (11%), or PBC (9%) (P <.001). This pattern was associated with a significantly increased risk for HCC in patients with cirrhosis and HBV-, HCV-, and ALC-related disease but not in those with HDV-related disease and PBC.
  
  
  CONCLUSIONS
  The coarse nodular pattern is more often seen in patients with HDV-related cirrhosis, and, in this setting (in contrast to HBV-, HCV-, and ALC-related cirrhosis, as well as in PBC), it does not represent an added risk factor for HCC.
authors.affiliation: Department of Anatomy and Histopathology, Gastroenterology Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy. e.caturelli@tiscalinet.it
authors.forename: Eugenio
authors.initials: E
authors.lastname: Caturelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Castellano
authors.forename: Saverio
authors.initials: S
authors.lastname: Fusilli
authors.forename: Bruno
authors.initials: B
authors.lastname: Palmentieri
authors.forename: Grazia A
authors.initials: GA
authors.lastname: Niro
authors.forename: Camillo
authors.initials: C
authors.lastname: del Vecchio-Blanco
authors.forename: Angelo
authors.initials: A
authors.lastname: Andriulli
authors.forename: Ilario
authors.initials: I
authors.lastname: de Sio
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D003699:Hepatitis D / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008105:Liver Cirrhosis, Biliary / Q000150:complications; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography