Correlation between ultrasonographic and pathologic diagnoses of hepatitis B and C virus-related cirrhosis.
BACKGROUND. We aimed to evaluate the validity of ultrasonography (US) in the diagnosis of cirrhosis in patients with chronic hepatitis B virus (HBV) or C virus (HCV) infection.


METHODS
A total of 210 patients, 67 with chronic HBV and 143 with HCV infection, were evaluated for the cirrhotic status of liver by both needle biopsy and US. According to the pathological findings, a fibrosis score 4 on the histology activity index was the gold standard for the diagnosis of cirrhosis. A US scoring system consisting of liver surface, parenchyma, vascular structure, and splenic size was used to describe the severity of hepatic parenchymal damage.


RESULTS
Cirrhosis was found in 27 (40%) of the 67 HBV patients and in 51 (36%) of the 143 HCV patients pathologically. The mean fibrosis scores were 0.95, 1.24, 2.35, 2.95, 3.8 and 3.7 in patients with US scores of 4, 5, 6, 7, 8, and 9 or more, respectively. The US scores were significantly correlated with the hepatic fibrosis scores (P < 0.05). Based on the receiver operating characteristic (ROC) curve, a US score of 7 was the best cutoff point for the prediction of HBV-related cirrhosis, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 77.8%, 92.5%, 87.5%, 86.0%, and 86.6%, respectively. In HCV-related cirrhosis, a US score of 6 provided results of 82.4%, 70.7%, 60.9%, 87.8%, and 74.8%, respectively. The specificity, positive predictive value, and accuracy were significantly higher in patients with HBV than in those with HCV infection (P = 0.012, P = 0.032, and P= 0.079, respectively).


CONCLUSIONS
Cirrhosis can be predicted well by US, especially in patients with HBV infection.
Hung
Chao-Hung
CH
Division of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, 123 Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan.
Lu
Sheng-Nan
SN
Wang
Jing-Houng
JH
Lee
Chuan-Mo
CM
Chen
Tsung-Ming
TM
Tung
Hung-Da
HD
Chen
Chien-Hung
CH
Huang
Wu-Shiung
WS
Changchien
Chi-Sin
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography