title: Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C.
abstract: BACKGROUND
  Hepatitis C is an important cause of chronic liver disease worldwide. The grading of hepatic fibrosis in chronic hepatitis C is important for better clinical management. However, until now, liver biopsy is the only test accepted for this purpose, despite their contraindications and complications. New methods for non-invasive assessment of hepatic fibrosis are under investigation. One proposal is the Doppler ultrasound, as a non-invasive, widely available and inexpensive.
  
  
  OBJECTIVE
  To compare Doppler parameters of portal vein in patients with chronic hepatitis C with a healthy control group and to correlate these parameters with fibrosis degree obtained by liver biopsy.
  
  
  METHODS
  Fifty patients with chronic hepatitis C submitted to liver biopsy and 44 healthy controls had Doppler of the portal vein performed, with the calculation of the portal venous index. We conducted a comparison between the averages of the two groups of portal venous index. For the correlation between portal venous index and fibrosis was employed the Spearman test.
  
  
  RESULTS
  There was a difference between the average portal venous index between controls (0.33 ± 0.07) and patients (0.23 ± 0.09) with P<0.001. No difference was observed between the portal venous index in patients with chronic hepatitis C who have significant fibrosis or not. The correlation between the portal venous index and fibrosis degree was reverse and moderate (r =-0.448 P<0.001). The area under the ROC curve was 78.4% (95% CI: 68.8% to 88%). The cutoff for the portal venous index was 0.28 with sensitivity of 73.5% and specificity of 71.1%.
  
  
  CONCLUSIONS
  The portal venous index was useful in distinguishing healthy patients from patients with CHC. However, there was no significant difference in the quantification of degree of fibrosis.
authors.affiliation: Serviço de Gastroenterologia, Hospital de Clínicas, Universidade Federal de Uberlândia, Brazil. haroldoluisrocha@yahoo.com.br
authors.forename: Haroldo Luis Oliva Gomes
authors.initials: HL
authors.lastname: Rocha
authors.forename: Angélica Lemos Debs
authors.initials: AL
authors.lastname: Diniz
authors.forename: Valéria Ferreira de Almeida e
authors.initials: VF
authors.lastname: Borges
authors.forename: Frederico Chaves
authors.initials: FC
authors.lastname: Salomão
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult