Non-invasive assessment of fibrosis using color Doppler ultrasound in patients with hepatitis C virus in the Amazon rainforest, Brazil.
The purpose of this study was to correlate morphologic and hemodynamic Doppler ultrasound findings as indicators of the degree of inflammation and fibrosis and to diagnose chronic vital hepatitis complications and progression. A prospective, descriptive study of a case series was conducted that analyzed Doppler ultrasound images of the liver and portal system and used the portal vein congestion index, hepatic and splenic artery impedance indices, and the liver vascular index. Of 50 patients positive for antibodies against hepatitis C virus, morphologic changes highlighted increased hepatic parenchyma echogenicity in 24%, and increased gall blander echogenicity and wall thickness in 4%. The most common hemodynamic changes observed were reduced flow velocity in the portal vein trunk in 26%, congestion index changes in 12%, liver vascular index changes in 16%, and splenic and hepatic artery impedance index changes in 14%. These indices were shown to be associated with alanine aminotransferase levels, which suggested that they are important liver damage indicators in the early phase of infection with hepatitis C virus.
Universidade do Estado do Amazonas, Fundação de Medicina Tropical Heitor Vieira Dourado, Gerência de Virologia, Manaus, Amazonas, Brazil. jorgeleao18@hotmail.com
Jorge
J
Leão
Marianna
M
Brock
Márcia
M
Castilho
André
A
Scariot
Ana
A
Scariot
Wornei
W
Braga
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D001938:Brazil; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D006439:Hemodynamics; D016174:Hepacivirus / Q000302:isolation & purification*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D018615:Ultrasonography, Doppler, Color
D000410:Alanine Transaminase