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The Accuracy of Sonography in Predicting Steatosis and Fibrosis in Chronic Hepatitis C

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Abstract

The accuracy and clinical significance of sonography (US) in demonstrating fatty liver and hepatic fibrosis in chronic hepatitis C (CHC) are rarely reported. US had sensitivity 71.1%, specificity 72.9%, 58.7% positive predictive value (PPV), and 82.3% negative predictive value (NPV) in demonstrating histological steatosis ≥5%. US had sensitivity 85.7%, specificity 60.4%, 13% PPV, and 98.4% NPV in demonstrating histological steatosis ≥30% with clinical significance in predicting prognosis and therapeutic response in CHC. Subjects with fatty liver on US had a greater prevalence of body mass index (BMI) ≥25 kg/m2, inflammation-necrosis grade >2, and total bilirubin <1.2 mg/dl in multivariate analyses. US had sensitivity 27.4%, specificity 62.5%, 71.9% PPV, and 19.7% NPV in demonstrating histological fibrosis of stage II or above, and sensitivity 13.6%, specificity 66.3%, 9.4% PPV, and 75.0% NPV in demonstrating fibrosis of stage III or above. There was no correlation between fibrotic sonographic patterns and histological stage of fibrosis (r = −0.167, P = 0.083). Besides hepatic steatosis, clinicians should be alert to the possibility of advanced necrosis-inflammation grade in interpreting a report of bright liver on gray-scale US. Gray-scale US cannot replace liver biopsy as the optimal diagnostic procedure for the prediction of hepatic steatosis and fibrosis prior to initiating therapy for CHC.

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Authors and Affiliations

  1. Digestive Disease Center, Changhua Show-Chwan Memorial Hospital, No 542, Section 1, Chung-Shang Road, Changhua, 500, Taiwan

    Chien-Hua Chen, Chi-Chieh Yang & Yung-Hsiang Yeh

  2. Digestive Disease Center, Chang-Bing Show-Chwan Memorial Hospital, No 542, Section 1, Chung-Shang Road, Changhua, 500, Taiwan

    Chien-Hua Chen & Yung-Hsiang Yeh

  3. Department of Healthcare Administration, Meiho Institute of Technology, No 542, Section 1, Chung-Shang Road, Changhua, 500, Taiwan

    Chien-Hua Chen & Yung-Hsiang Yeh

  4. Depatment of Pathology, Changhua Show-Chwan Memorial Hospital, No 542, Section 1, Chung-Shang Road, Changhua, 500, Taiwan

    Shang-Tao Lin & Chien-Long Kuo

  5. Department of Medical Research, Changhua Show-Chwan Memorial Hospital, No 542, Section 1, Chung-Shang Road, Changhua, 500, Taiwan

    Chiu-Kue Nien

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  1. Chien-Hua Chen
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Correspondence to Chien-Hua Chen.

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Chen, CH., Lin, ST., Yang, CC. et al. The Accuracy of Sonography in Predicting Steatosis and Fibrosis in Chronic Hepatitis C. Dig Dis Sci 53, 1699–1706 (2008). https://doi.org/10.1007/s10620-007-0048-2

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  • DOI: https://doi.org/10.1007/s10620-007-0048-2

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