Ultrasound differentiates between hepatitis and cirrhosis

Simple gray scale and color Doppler sonography can show differences between compensated liver cirrhosis and chronic viral hepatitis in patients with liver problems. Certain color Doppler indices can even help narrow down the stage of chronic viral hepatitis, reducing the need for biopsies.

Dr. Panagiotis Iliopoulos from Agios Andreas General Hospital in Patras, Greece, and colleagues from hospitals around Patras and Thessaly published their research in the September issue of the Journal of Gastrointestinal and Liver Diseases. The study included 44 patients with chronic viral hepatitis, 28 with compensated liver cirrhosis, and 32 healthy individuals as a control group.

The diagnoses for patients with liver problems were confirmed with a liver biopsy. Gray scale and color Doppler ultrasound exams were performed on the liver, portal vein, hepatic artery, and spleen of all individuals in the study and several known indices were calculated using these measurements. In addition, the researchers used these measurements to calculate three more fairly straightforward indices to assess the functioning of the liver and major blood vessels.

Statistical analysis showed that the congestion index of the portal vein and two of the researchers' alternative indices (the hepatic artery time average mean velocity/portal vein time average mean velocity ratio, and the portal vein diameter over time average maximum velocity index) could be used to discriminate between hepatitis and cirrhosis.

In addition, a formula including the three liver variables of enlargement, echogenicity, and diffusion, along with spleen volume and four of the calculated indices, correctly classified 88.9% of the patients into either the chronic viral hepatitis group or the compensated liver cirrhosis group.

The researchers also found significant differences in hemodynamic parameters and indices for those patients whose chronic viral hepatitis had progressed to stage five.

They concluded that gray scale and color Doppler ultrasound could be used to differentiate between chronic viral hepatitis and compensated liver cirrhosis and could help monitor chronic viral hepatitis. This could improve management of the diseases and help avoid unnecessary biopsies.