Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis.
OBJECTIVE
To assess the value of gray scale (GS) and colour Doppler ultrasonography (CDU) in differentiating the progression of chronic viral hepatitis (CVH) and compensated liver cirrhosis (CIR).


METHODS
Seventy-two patients and 32 normal individuals who were used as controls were studied. Forty-four patients suffered from CVH and 28 from CIR. All patients were underwent to liver biopsy. Multiple qualitative and quantitative variables were studied in liver, portal vein (PV), hepatic artery (HA) and spleen with GS and CDU. On the basis of the obtained CDU data, several known indexes were calculated. In addition, alternative indices [PV diameter (D)/time average mean velocity (VTAM), HA/PV VTAM ratio] were calculated and studied.


RESULTS
ROC analysis showed that PV congestion index, PV D/VTAM and HA/PV VTAM indices had the best sensitivity and specificity in discriminating CVH from CIR. Stepwise discriminant analysis showed that 88.9% of the originally grouped cases could be correctly classified by the three qualitative and four quantitative variables selected as statistically significant predictors. Among the CVH patients who underwent to biopsy, statistically significant changes were found in those at fibrosis stage 5 compared to fibrosis stages 1-4.


CONCLUSIONS
Simple GS and CDU parameters discriminate CVH from CIR. The alternative Doppler indexes can accurately differentiate chronic virus hepatitis from cirrhosis. These indexes can be used in monitoring chronic virus hepatitis and avoiding unnecessary biopsies.
Iliopoulos
Panagiotis
P
Department of Radiology, Agios Andreas General Hospital, Greece. eliopan@otenet.gr
Vlychou
Marianna
M
Karatza
Chrisoula
C
Yarmenitis
Spyros-D
SD
Repanti
Maria
M
Tsamis
Ioannis
I
Tepetes
Kostantinos
K
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006505:Hepatitis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods