title: The accuracy of sonography in predicting steatosis and fibrosis in chronic hepatitis C.
abstract: The accuracy and clinical significance of sonography (US) in demonstrating fatty liver and hepatic fibrosis in chronic hepatitis C (CHC) are rarely reported. US had sensitivity 71.1%, specificity 72.9%, 58.7% positive predictive value (PPV), and 82.3% negative predictive value (NPV) in demonstrating histological steatosis > or =5%. US had sensitivity 85.7%, specificity 60.4%, 13% PPV, and 98.4% NPV in demonstrating histological steatosis > or =30% with clinical significance in predicting prognosis and therapeutic response in CHC. Subjects with fatty liver on US had a greater prevalence of body mass index (BMI) > or =25 kg/m2, inflammation-necrosis grade >2, and total bilirubin <1.2 mg/dl in multivariate analyses. US had sensitivity 27.4%, specificity 62.5%, 71.9% PPV, and 19.7% NPV in demonstrating histological fibrosis of stage II or above, and sensitivity 13.6%, specificity 66.3%, 9.4% PPV, and 75.0% NPV in demonstrating fibrosis of stage III or above. There was no correlation between fibrotic sonographic patterns and histological stage of fibrosis (r = -0.167, P = 0.083). Besides hepatic steatosis, clinicians should be alert to the possibility of advanced necrosis-inflammation grade in interpreting a report of bright liver on gray-scale US. Gray-scale US cannot replace liver biopsy as the optimal diagnostic procedure for the prediction of hepatic steatosis and fibrosis prior to initiating therapy for CHC.
authors.affiliation: Digestive Disease Center, Changhua Show-Chwan Memorial Hospital, No 542, Section 1, Chung-Shang Road, Changhua 500, Taiwan. peach@show.org.tw
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Chen
authors.forename: Shang-Tao
authors.initials: ST
authors.lastname: Lin
authors.forename: Chi-Chieh
authors.initials: CC
authors.lastname: Yang
authors.forename: Yung-Hsiang
authors.initials: YH
authors.lastname: Yeh
authors.forename: Chien-Long
authors.initials: CL
authors.lastname: Kuo
authors.forename: Chiu-Kue
authors.initials: CK
authors.lastname: Nien
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography