title: Usefulness of B-mode and doppler sonography for the diagnosis of severe acute viral hepatitis A.
abstract: BACKGROUND
  To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection.
  
  
  METHODS
  Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (V(PORTAL)) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥ 15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated.
  
  
  RESULTS
  Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly (p < 0.05). V(PORTAL) was inversely correlated with MELD score (r = -0.485) and several laboratory markers. The hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of V(PORTAL) was 0.798. It reached 0.869 in the patients with typical GB change.
  
  
  CONCLUSIONS
  Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection.
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Shin
authors.affiliation: Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.|Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Woo Kyoung
authors.initials: WK
authors.lastname: Jeong
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Yongsoo
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.|Department of Radiology, Ajou University Hospital, Ajou University College of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea.
authors.forename: Jinoo
authors.initials: J
authors.lastname: Kim
authors.affiliation: Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Hwan Cheol
authors.initials: HC
authors.lastname: Park
authors.affiliation: Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006506:Hepatitis A / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging; D012372:ROC Curve; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging; D013163:Splenomegaly / Q000150:complications / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D055815:Young Adult
keywords: Doppler; acute hepatitis; fulminant hepatic failure; hepatitis A virus; ultrasonography