Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis.
OBJECTIVE
To evaluate the validity of ultrasonographic and pathologic diagnosis of liver fibrosis in patients with chronic viral hepatitis.


METHODS
The liver fibrosis status in 324 patients was evaluated by both needle biopsy and ultrasonography. Liver fibrosis was divided into S0-S4 stages. S4 stage was designated as definite cirrhosis. The ultrasonographic examination included qualitative variables, description of liver surface and parenchyma, and quantitative parameters, such as diameter of vessels, blood flow velocity and spleen size.


RESULTS
Ultrasonographic qualitative description of liver surface and parenchyma was related with the severity of fibrosis. Among the quantitative ultrasonographic parameters, cut-off value of spleen length (12.1 cm) had a sensitivity of 0.600 and a specificity of 0.753 for diagnosis of liver cirrhosis. The diameters of spleen (8 mm) and portal vein (12 mm) had a diagnostic sensitivity of 0.600 and 0.767, and a diagnostic specificity of 0.781 and 0.446, respectively. The diagnostic accuracy for liver cirrhosis was moderately satisfactory, and the negative predictive values of these parameters reached near 0.95.


CONCLUSIONS
Ultrasonography can predict the degree of liver fibrosis or cirrhosis. A single ultrasonographic parameter is limited in sensitivity and specificity for the diagnosis of early cirrhosis. The presence or absence of liver cirrhosis in patients with chronic virus hepatitis can be detected using 2 or 3 quantitative and qualitative parameters, especially the length of spleen, the diameter of spleen vein and echo pattern of liver surface.
Department of Gastroenterology, Shanghai Second Medical University Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai 200001, China. leishenl@yahoo.com
Lei
L
Shen
Ji-Qiang
JQ
Li
Min-De
MD
Zeng
Lun-Gen
LG
Lu
Si-Tao
ST
Fan
Han
H
Bao
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000098:blood supply / Q000473:pathology; D018608:Ultrasonography, Doppler