Ultrasound based evaluation of hepatic steatosis and fibrosis in hepatitis C non-responders.
OBJECTIVE
To determine the accuracy of ultrasound in the diagnosis and grading of steatosis and fibrosis in Hepatitis C (HCV) patients not responding to ribavarin-interferon therapy.


METHODS
A cross-sectional, analytical study.


METHODS
Radiology Department, Civil Hospital, Karachi, from March 2008 to August 2010.


METHODS
Patients with positive HCV RNA despite 24 weeks ribavarin-interferon therapy (non-responders) were subjected to ultrasound and biopsy prior to institution of pegylated interferon therapy for detection and grading of steatosis and fibrosis. Using histopathology as the gold standard, sensitivity, specificity, negative and positive predictive values for ultrasound were determined.


RESULTS
The sensitivity of ultrasound for hepatic steatosis was 90.9% for no steatosis (NS), 100% for moderate and gross steatosis and 84.4% for mild steatosis with 100% specificity. The sensitivity for fibrosis was 25% for no fibrosis, 100% for mild fibrosis, 89.74% for moderate fibrosis and 100% for gross fibrosis. The overall accuracy for detection of steatosis was 95.39% and that for fibrosis was 98.02%. Hepatic vein showed increased dampening of flow with advancing grades of steatosis and fibrosis.


CONCLUSIONS
Ultrasound has a high accuracy in the diagnosis and grading of steatosis and fibrosis in HCV nonresponders. Mild fibrosis may confound the diagnosis of mild steatosis.
Department of Radiology, DMC/DUHS, Civil Hospital, Karachi, Pakistan. drsabasohail@hotmail.com
Saba
S
Sohail
Sina'
S
Aziz
Talat
T
Mirza
D000328:Adult; D000368:Aged; D001706:Biopsy; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005355:Fibrosis; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012254:Ribavirin / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D014463:Ultrasonography; D055815:Young Adult
D012254:Ribavirin; D007372:Interferons