Year 2003 / Volume 95 / Number 4
Original
Ultrasonography in patients with chronic liver disease: its usefulness in the diagnosis of cirrhosis

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M. A. Macías Rodríguez, P. Rendón Unceta, C. Navas Relinque, M. Tejada Cabrera, J. M. Infantes Hernández y L. Martín Herrera

Abstract
Objective: to prospectively assess the usefulness of ultrasonography in predicting the presence of cirrhosis in patients with asymptomatic chronic liver disease in unknown stage.
Experimental design: eighteen doppler and ultrasonographic features were prospectively assessed immediately before performing laparoscopy and/or liver biopsy. Usefulness of
predictive variables selected by multiple regression analysis and included in a scoring scale was determined by ROC curves.

Patients: one hundred and thirteen consecutive patients with neither clinical nor biochemical signs of advanced liver disease submitted for study.
Results: liver enlargement, liver surface nodularity, liver parenchyma distortion, flattening of flow wave in hepatic veins, portal and splenic veins dilatation, decreased variability in splenic vein
caliber with breathing, collateral vessels, and splenomegaly were associated to cirrhosis. Multivariate analysis showed the joint assessment
of hepatic echostructure, portal vein caliber and spleen area to be the best approach to ultrasonographic staging, with sensitivity of 80%, specificity of 92% and accuracy of 89% in the
diagnosis of cirrhosis.

Conclusions: ultrasonography enabled the presence or absence of cirrhosis to be correctly determined even in patients with
asymptomatic disease. Combined assessment of hepatic echostructure, portal vein diameter and spleen size provides the highest accuracy.
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M. A. Macías Rodríguez, P. Rendón Unceta, C. Navas Relinque, M. Tejada Cabrera, J. M. Infantes Hernández y L. Martín Herrera. Ultrasonography in patients with chronic liver disease: its usefulness in the diagnosis of cirrhosis. 0


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