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Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis
OBJECTIVE: To determine the diagnostic accuracy of routine clinical ultrasound in the staging of liver fibrosis in chronic viral hepatitis. MATERIALS AND METHODS: A retrospective evaluation of the ultrasound images of 156 patients with chronic viral hepatitis who underwent liver biopsy was performed...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2012
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515928/ https://www.ncbi.nlm.nih.gov/pubmed/23230540 http://dx.doi.org/10.4103/2156-7514.101000 |
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author | Choong, Chih-Ching Venkatesh, Sudhakar K. Siew, Edwin P. Y. |
author_facet | Choong, Chih-Ching Venkatesh, Sudhakar K. Siew, Edwin P. Y. |
author_sort | Choong, Chih-Ching |
collection | PubMed |
description | OBJECTIVE: To determine the diagnostic accuracy of routine clinical ultrasound in the staging of liver fibrosis in chronic viral hepatitis. MATERIALS AND METHODS: A retrospective evaluation of the ultrasound images of 156 patients with chronic viral hepatitis who underwent liver biopsy was performed. Two radiologists in consensus, blind to the biopsy results and clinical details, evaluated the ultrasound images for liver fibrosis. The readers specifically assessed three features — surface nodularity, liver edge, and parenchymal echotexture — with scores of 0 to 3 (0 = normal, 1 = mild, 2 = moderate, 3 = severe). Accuracies of each sonographic feature for the detection of mild fibrosis and above (≥F1), significant fibrosis (≥F2), severe fibrosis (≥F3), and cirrhosis (F4) were determined with histopathology as the reference standard. RESULTS: Fibrosis was present in 99 patients (F1=34, F2=20, F3=22, and F4=23) and absent in 57 patients. The sensitivities for the detection of significant fibrosis with surface nodularity, liver edge, and parenchymal echotexture were 57%, 15%, and 41%, respectively. The accuracies for the detection of ≥F1, ≥F2, ≥F3, and F4 stages were 50.5%, 59%, 59%, and 65% for liver surface, 51%, 53%, 54%, and 55% for liver edge, and 58%, 59%, 63%, and 63% for parenchyma echotexture, respectively. The combined scores from all three features had accuracies of 56%, 59%, 62%, and 66% for the detection of ≥F1, ≥F2, ≥F3, and F4, respectively. CONCLUSION: Routine clinical ultrasound is a not a sensitive predictor of early fibrosis in chronic viral hepatitis. Surface nodularity is the most sensitive sonographic feature for the detection of significant fibrosis and routine clinical ultrasound is the most useful for the detection of cirrhosis. |
format | Online Article Text |
id | pubmed-3515928 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-35159282012-12-10 Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis Choong, Chih-Ching Venkatesh, Sudhakar K. Siew, Edwin P. Y. J Clin Imaging Sci Original Article OBJECTIVE: To determine the diagnostic accuracy of routine clinical ultrasound in the staging of liver fibrosis in chronic viral hepatitis. MATERIALS AND METHODS: A retrospective evaluation of the ultrasound images of 156 patients with chronic viral hepatitis who underwent liver biopsy was performed. Two radiologists in consensus, blind to the biopsy results and clinical details, evaluated the ultrasound images for liver fibrosis. The readers specifically assessed three features — surface nodularity, liver edge, and parenchymal echotexture — with scores of 0 to 3 (0 = normal, 1 = mild, 2 = moderate, 3 = severe). Accuracies of each sonographic feature for the detection of mild fibrosis and above (≥F1), significant fibrosis (≥F2), severe fibrosis (≥F3), and cirrhosis (F4) were determined with histopathology as the reference standard. RESULTS: Fibrosis was present in 99 patients (F1=34, F2=20, F3=22, and F4=23) and absent in 57 patients. The sensitivities for the detection of significant fibrosis with surface nodularity, liver edge, and parenchymal echotexture were 57%, 15%, and 41%, respectively. The accuracies for the detection of ≥F1, ≥F2, ≥F3, and F4 stages were 50.5%, 59%, 59%, and 65% for liver surface, 51%, 53%, 54%, and 55% for liver edge, and 58%, 59%, 63%, and 63% for parenchyma echotexture, respectively. The combined scores from all three features had accuracies of 56%, 59%, 62%, and 66% for the detection of ≥F1, ≥F2, ≥F3, and F4, respectively. CONCLUSION: Routine clinical ultrasound is a not a sensitive predictor of early fibrosis in chronic viral hepatitis. Surface nodularity is the most sensitive sonographic feature for the detection of significant fibrosis and routine clinical ultrasound is the most useful for the detection of cirrhosis. Medknow Publications & Media Pvt Ltd 2012-09-25 /pmc/articles/PMC3515928/ /pubmed/23230540 http://dx.doi.org/10.4103/2156-7514.101000 Text en Copyright: © 2012 Choong CC http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Choong, Chih-Ching Venkatesh, Sudhakar K. Siew, Edwin P. Y. Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title | Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title_full | Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title_fullStr | Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title_full_unstemmed | Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title_short | Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis |
title_sort | accuracy of routine clinical ultrasound for staging of liver fibrosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515928/ https://www.ncbi.nlm.nih.gov/pubmed/23230540 http://dx.doi.org/10.4103/2156-7514.101000 |
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