Ultrasonography on semi-quatitative diagnosis of liver fibrosis and cirrhosis: observation of surface configuration and ligaments of liver / 中华超声影像学杂志

ABSTRACT

Objective To observe the degree of liver su rface abnormality using high frequency probes and additional methods and to investigate the diagnostic value of semi-quatitative grading in liver fibrosis and cirrhosis. Methods One hundred and twenty-seven cases of cirrhosis (including 83 cases of hepatocelular carcinoma) confirmed by operation and pathology were enrolled in the group while 56 cases of non-cirrhotic patients with no clinical signs and negative surgical gross findings (operation for other kinds of tumors) served as the control. Five additional methods such as high frequency probes, harmonic technique, local zooming out, regulating focus and decreasing gain were used to observe the configuration and thickness of liver surface. Five-grade classification of liver surface was adopted as follows thin and regular-grade 0; slightly thickened with increased echogenicity-grade Ⅰ; thickened like fine ripples-grade Ⅱ; significantly thickened with segmental incontinuence-grade Ⅲ; significantly thickened like waves-grade Ⅳ. Observation on configuration of the round ligament thin, regular with the thickness ≤2 mm was considered as normal whereas thickened, irregular with increased echogenicity as abnormal. Results Of the 127 cases in the study group, 11 cases were grade 0, and grade Ⅰ 21 cases, grade Ⅱ 27 cases, grade Ⅲ 32 cases, grade Ⅳ 36 cases. In the control group there were 48 cases of grade 0 and 8 cases of grade Ⅰ-Ⅱ. The sensitivity, specificity and accuracy of liver surface detection with this method were 91.3-%, 85.7-%, 89.6-%, respectively. 75% (9/12 cases) patients with liver fibrosis and 95.5%- patients ( 64/67- cases) with cirrhosis were found with abnormality of hepatic ligaments in the study group. While only 4 cases ( 8.9-%) with abnormality appeared in the control group.Conclusions Grading of changes in liver surface might sensitively reflect their pathological changes. In addition, it would be a reliable method in the diagnosis of liver fibrosis and early stage cirrhosis as well as a semi-quatitative diagnostic tool for advancement of diffuse liver diseases.