Accuracy of ultrasonography in detection of severe liver fibrosis/cirrhosis in chronic liver disease

ABSTRACT

To determine the accuracy of three ultrasonographic [US] signs; liver surface nodularity, caudate lobe hypertrophy and hepatic vein flow pattern on Doppler ultrasound, in detecting severe liver fibrosis in chronic liver disease. Descriptive study. Department of Diagnostic Radiology, PNS Shifa Karachi. Duration of the study was 6 months -SEPTEMBER 2005 TO MARCH 2006. The study included 50 patients of both sexes [20-60 yrs], presenting with chronic liver disease to department of Ultrasound. TOSHIBA [NEMIO- 20] Doppler Ultrasound Machine with Doppler 3.5 and 5.0MHz probes was used to look for liver surface nodularity, caudate lobe hypertrophy and pattern of hepatic vein flow. After performing US, liver biopsy on these patients was performed under US guidance and sent for histopathology findings; taken as gold standard. On US, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were highest for liver surface nodularity in detecting severe liver fibrosis. However, the above-mentioned values were relatively higher when the three ultrasound signs were collectively considered; compared to single US sign. US determination of liver surface nodularity is a significantly accurate method for identifying severe liver fibrosis or cirrhosis. The accuracy of ultrasound further increases when hepatic vein flow pattern and caudate lobe hypertrophy are also taken into account