Ultrasonic diagnosis of cirrhosis: Reference to quantitative measurements of hepatic dimensions

Goyal, Ashish; Pokharna, D. S.; Sharma, Saurabh

doi:10.1007/bf01888729

Cited by 34 publications

(14 citation statements)

References 10 publications

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“…In our study, spleen volume was increased in CVH and cirrhotic patients compared with the controls, which is consistent with the findings in other studies [19,20,22,[24][25][26][28][29][30][31]38] . It is well known that a relative interobser ver variability may limit the value for gray scale and Doppler ultrasonography [33][34][35][36] .…”

Section: Introductionsupporting

confidence: 93%

“…However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography in Differentiation Between Chronic Viral Hepatitis and Compensated Early Stage Cirrhosis

2008

Ultrasound Quarterly

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minate CVH from CIR. The alternative Doppler indexes can accurately differentiate chronic virus hepatitis from cirrhosis. These indexes can be used in monitoring chronic virus hepatitis and avoiding unnecessary biopsies. INTRODUCTIONChronic viral hepatitis, mainly caused by hepatitis virus B or C, results in liver parenchyma damage and inflammation and may lead to fibrosis, cirrhosis and/or hepatocellular carcinoma [1][2][3] . Cirrhosis often occurs as an indolent disease and a lot of patients remain asymptomatic [4,5] until the occurrence of decompensation, and are characterised by portal hypertension, variceal bleeding, ascites and hepatic encephalopathy.Liver biopsy is the gold standard for diagnosis and determination of the fibrosis and necroinflammatory changes in chronic viral hepatitis and cirrhosis. However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations. Therefore, positive correlation studies have usually referred to the velocity ratio of hepatic RESULTS: ROC analysis showed that PV congestion index, PV D/VTAM and HA/PV VTAM indices had the best sensitivity and specificity in discriminating CVH from CIR.Stepwise discriminant analysis showed that 88.9% of the originally grouped cases could be correctly classified by the three qualitative and four quantitative variables selected as statistically significant predictors. Among the CVH patients who underwent to biopsy, statistically significant changes were found in those at fibrosis stage 5 compared to fibrosis stages 1-4.

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Section: Introductionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Ultrasonography in Differentiation Between Chronic Viral Hepatitis and Compensated Early Stage Cirrhosis

2008

Ultrasound Quarterly

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“…Alterations in liver morphology such as atrophy of the right lobe and left medial segment, hypertrophy of the left lateral segment and caudate lobe, enlargement of the pericholecystic and periportal spaces, nodular liver surface, abnormal hepatic texture at US and inhomogeneous attenuation at CT or inhomogeneous signal intensity at MRI have been documented as an indication of regenerative nodules. Furthermore, blunt liver edge, collateral circulation, splenomegaly and ascites were described as important imaging findings of LC in previous studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][26][27][28][29][30] .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Imaging for Liver Cirrhosis Compared to Histologically Proven Liver Cirrhosis

et al. 2008

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Objective: To evaluate the diagnostic accuracy of liver cirrhosis by imaging modalities, including CT, MRI and US, compared to results obtained from histopathological diagnoses of resected specimens. Materials and Methods: CT, MRI and US examinations of 142 patients with chronic liver disease who underwent surgery for complicated hepatocellular carcinoma (<3 cm in diameter) in 10 institutions were blindly reviewed in a multicenter study by three radiologists experienced in CT, MRI and US. The images were evaluated for five imaging parameters (irregular or nodular liver surface, blunt liver edge, liver parenchymal abnormalities, liver morphological changes and manifestations of portal hypertension) using a severity scale. The diagnostic imaging impression score was also calculated. Patients were histologically classified into chronic hepatitis (CH; n = 54), liver cirrhosis (LC; n = 71) and pre-cirrhosis (P-LC; n = 17) by three pathologists, independently, who reviewed the resected liver specimens. The results of the three imaging methods were compared to those from histological diagnoses, and a multivariate analysis (stepwise forward logistic regression analysis) was performed to identify independent predictive signs of cirrhosis. The diagnostic efficacies for LC and early cirrhosis were also compared among CT, MRI and US using a receiver-operating characteristic (ROC) curve analysis. Results: The differences in the five imaging parameters evaluated by CT, MRI and US between LC and CH were statistically significant (p < 0.001) except for the manifestations of portal hypertension on US. Irregular or nodular surface, blunt edge or morphological changes in the liver were selected as the best predictive signs for cirrhosis on US whereas liver parenchymal abnormalities, manifestations of portal hypertension and morphological changes in the liver were the best predictive signs on MRI and CT by multivariate analysis. The predictive diagnostic accuracy, sensitivity and specificity in discriminating LC from CH based on the best predictive signs were 71.9, 77.1 and 67.6% by CT; 67.9, 67.5 and 68.3% by MRI, and 66.0, 38.4 (lower than CT and MRI, p =0.001) and 88.8% (higher than CT and MRI, p =0.001)by US. According to the imaging impression scoring system, diagnostic accuracy, sensitivity and specificity were 67.0, 84.3 and 52.9% by CT; 70.3, 86.7 and 53.9% by MRI, and 64.0, 52.4 (lower than CT and MRI, p =0.0001) and 73.5% (higher than CT and MRI, p < 0.003) by US. ROC analysis showed that MRI and CT were slightly superior to US in the diagnosis of LC but no statistically significant difference was found between them. For the pathological diagnosis of P-LC, cirrhosis was diagnosed in 59.5, 46.7 and 41.7% of the P-LC cases by US, CT and MRI, respectively, with no significant difference among these methods. Conclusion: US, CT and MRI had different independent predictive signs for the diagnosis of LC. MRI and CT were slightly superior to US in predicting cirrhosis, especially regarding sensitivity. Noninvasive imaging techniqu...

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“…Prior reports have indicated that these findings were highly diagnostic signs of cirrhosis on cross-sectional imaging (1)(2)(3)(4)(5)(6)(7)(8)(9)(10).…”

mentioning

confidence: 91%

Enlargement of hilar periportal space: A sign of early cirrhosis at MR imaging

Ito¹,

Mitchell²,

Gabata³

2000

J. Magn. Reson. Imaging

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Ultrasonic diagnosis of cirrhosis: Reference to quantitative measurements of hepatic dimensions

Cited by 34 publications

References 10 publications

Ultrasonography in Differentiation Between Chronic Viral Hepatitis and Compensated Early Stage Cirrhosis

Ultrasonography in Differentiation Between Chronic Viral Hepatitis and Compensated Early Stage Cirrhosis

Diagnostic Accuracy of Imaging for Liver Cirrhosis Compared to Histologically Proven Liver Cirrhosis

Enlargement of hilar periportal space: A sign of early cirrhosis at MR imaging

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