Evaluation of Chronic Liver Disease: Does Ultrasound Scoring Criteria Help?

Abstract

Noninvasive approaches for assessment of liver histology include routine laboratory tests and radiological evaluation. The purpose of our study was to determine the utility of a simplified scoring system based on routinely evaluated ultrasound features for the evaluation of chronic liver disease and correlate it with the histological findings. For this cross-sectional analytical study the data was collected prospectively by nonprobability purposive sampling technique. The ultrasound variables/parameters and their assigned scoring system that was a modified version adopted from published literature were evaluated. Sensitivity, specificity, positive and negative predictive values of the liver morphological score and combined score of liver morphology and sizes was determined using stage and grade as reference standard. Our results show a high sensitivity and PPV of liver morphological sonographic evaluation for the staging and grading of CLD respectively thus supporting it as a screening diagnostic strategy. Of the three liver morphology variables, specificity of liver surface evaluation was highest for the stage of fibrosis and grade of inflammation. The simplified ultrasound scoring system evaluated in our study is clinically relevant and reproducible for differentiating patients with CLD with mild or no fibrosis from moderate to severe fibrosis.

Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis

“…The diagnosis of cirrhosis was established on the basis of any three of the following radiologic features of cirrhosis: altered echo texture of liver, irregular margins, spleen diameter of >12 cm, portal vein diameter of >12 mm, and ascites. [11,12] Abdominal ultrasonography was performed to measure the maximum spleen bipolar diameter and right liver lobe diameter in millimeters, using US (TOSHIBA-apleo 50Model MCM17545TS), by single senior radiologist to minimize interobserver variability.…”

Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update

“…Several studies have been performed to assess liver fibrosis stages using various US parameters, such as liver size, the bluntness of the liver edge, the coarseness of the liver parenchyma, liver surface nodularity, spleen size, etc. [85,86].…”

Splenomegaly in Patients With Sideropenic Anemias: Clinical and Hematologic Significance

“…US scoring system was used to evaluate the edge, surface and parenchymal texture of the spleen. Score 0 means normal and score 1 means splenomegaly that was defined as an anteroposterior dimension > 13 cm, without any abnormality of the structure [17].…”