Ultraschall Med 2005; 26 - OP028
DOI: 10.1055/s-2005-917309

CORRELATION OF ULTRASONOGRAPHIC FINDINGS WITH HISTOPATHOLOGICAL DIAGNOSIS IN GENOTYPE4HCV RELATED CHRONIC LIVER DISEASES

MES El-Raziky 1, GE Esmat 2, HI El-makhzngy 2, MM El-zafry 3, HM Khattab 4
  • 1Tropical Medicine, Faculty of Medicine Cairo University, Mokkatam
  • 2Tropical Medicine, Faculty of Medicine Cairo University, Cairo
  • 3Tropical Medicine, Faculty of Medicine Cairo University, CairoMaadi
  • 4Pathology, Faculty of Medicine Cairo University, Cairo, Egypt

Purpose: Viral hepatitis C is one of the most prevalent infectious diseases in Egypt. It was found that 25–40% of the patients with chronic HCV would develop liver cirrhosis or even HCC. Prompt and effective treatment of HCV could postpone the development of cirrhosis. Liver pathology influences the response to antiviral treatment and hence the treatment decision. Currently, liver biopsy is still considered the gold standard for assessing liver histopathology. However, it is an invasive procedure and complications have been reported. Patients may be reluctant to undergo biopsies. Sampling error and difficulties in interpreting the biopsy tissue have been documented. Ultrasound is accurate for predicting the final diagnosis in patients with established cirrhosis and its sequlae. However, the diagnostic accuracy of routine US for early liver cirrhosis is low.

We designed this study to investigate the accuracy of ultrasonographic findings (Grey scale and color Doppler) in predicting the final diagnosis in patients with HCV related chronic liver disease in comparison to histopatholoical diagnosis.

Methods and Materials: The study was conducted on 80 patients with HCV related compensated liver disease (Child A) prior to antiviral therapy. Chronic HCV was confirmed by detectable HCV RNA, high ALT and liver biopsy. Active schistosomiasis was excluded.We assessed patients by conventional abdominal ultrasonographic examination as well as Doppler study of Portal Vein, Hepatic Artery, Hepatic veins flow pattern and Splenic vein.

Results: The HIA correlated positively with right lobe size in midclavicular line and negatively with hepatic artery resitive index. Fibrosis Stage was significantly related to liver Surface with a negative correlation with Portal vein Peak velocity. Steatosis grade correlated positively with liver texture and the left lobe size in midline, right lobe size in midclavicular line and quadrate lobe transverse diameter.

Conclusions: We conclude that the use of color Doppler could be of good value in non invasive assessment of liver pathology.