Advertisement

Gastrointestinal Radiology

, Volume 17, Issue 1, pp 74–78 | Cite as

Cirrhosis: Diagnosis by liver surface analysis with high-frequency ultrasound

  • Hector Ferral
  • Rene Male
  • Mario Cardiel
  • Luis Munoz
  • Francisco Quiroz y Ferrari
Article

Abstract

To determine the sensitivity, specificity, and predictive values of the sonographic analysis of liver surface irregularities for the diagnosis of cirrhosis, the authors conducted a prospective and blinded study in 70 subjects with abnormal liver function tests. All patients included underwent liver biopsy within 15 days of the sonographic study. Twenty-three subjects with no signs or symptoms of liver disease were examined to assess the sonographic appearance of normal liver surface. Studies were performed with a small-parts probe, high-frequency transducer (7.5 MHz). Three basic patterns of liver surface were found: type I, normal; type II, focal abnormality; and type III, diffuse irregularity. Considering diffuse surface irregularity as an objective sonographic sign of cirrhosis, the study's sensitivity was 87.5%, specificity 81.5%, and positive and negative predictive values were 80% and 88.5%, respectively. Disease prevalence for cirrhosis was 45%. We conclude that sonographic analysis of the liver surface is a useful noninvasive test for the diagnosis of cirrhosis in the appropriate clinical setting.

Key words

Liver, cirrhosis Liver, diseases Abdomen, ultrasound 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Galambos JT. Alcoholic liver disease, fatty liver and cirrhosis. In: Berk JE ed.Bockus gastroenterology 4th ed. Philadelphia: WB Saunders, 1985:2985–3048Google Scholar
  2. 2.
    Anthony PP, Ishak KG, Nayak NC et al. The morphology of cirrhosis.J Clin Pathol 1978;31:395–414PubMedGoogle Scholar
  3. 3.
    O'Brien MJ, Gottlieb LS. The liver and biliary tract. In: Robbins SL Cotran RS eds.Pathologic basis of disease. Philadelphia: WB Saunders, 1979:1009–1071Google Scholar
  4. 4.
    Van Ness MM, Diehl AM. Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes?Ann Intern Med 1989;111:473–478PubMedGoogle Scholar
  5. 5.
    Sherlock S. Chronic hepatitis and cirrhosis.Hepatology 1984;4:25S-28SGoogle Scholar
  6. 6.
    Progress Report. Liver biopsy in the diagnosis of cirrhosis.Gut 1970;11:275–278Google Scholar
  7. 7.
    Goyal AK, Pokharna DS, Sharma SK. Ultrasonic diagnosis of cirrhosis: reference to quantitative measurements of hepatic dimensions.Gastrointest Radiol 1990;15:32–34PubMedGoogle Scholar
  8. 8.
    Harbin WP, Robert NR, Ferruci JT. Diagnosis of cirrhosis based on regional changes in hepatic morphology.Radiology 1980;135:273–283PubMedGoogle Scholar
  9. 9.
    Dewbury KC, Clark MB. The accuracy of ultrasound in the detection of cirrhosis of the liver.Br J Radiol 1979;52:945–948PubMedGoogle Scholar
  10. 10.
    Giorgio A, Amoroso P, Lettieri G et al. Cirrhosis: value of caudate to right lobe ratio in diagnosis with ultrasound.Radiology 1986;161:443–445PubMedGoogle Scholar
  11. 11.
    Saverymuttu SH, Joseph AEA, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis.Br Med J 1986;292:13–15Google Scholar
  12. 12.
    Taylor KJW, Gorelick FS, Rosenfield AT, Riely CA. Ultrasonography of alcoholic liver disease with histological correlation.Radiology 1981;141:157–161PubMedGoogle Scholar
  13. 13.
    Sandford NL, Walsh P, Matis C, Baddeley H, Powell LW. Is ultrasonography useful in the assessment of diffuse parenchymal liver disease?Gastroenterology 1985;89:186–191PubMedGoogle Scholar
  14. 14.
    Debongnie JC, Puls C, Fievez M, Wibin E. Prospective evaluation of the diagnostic accuracy of liver ultrasonography.Gut 1981;22:130–135PubMedGoogle Scholar
  15. 15.
    Hess CF, Schmiedl U, Koebel G, Knecht R, Kurtz B. Diagnosis of liver cirrhosis with US: receiver-operating characteristic analysis of multidimensional caudate lobe indexes.Radiology 1989;171:349–351PubMedGoogle Scholar
  16. 16.
    Di Leilo A, Cestari C, Lomazzi A, Beretta L. Cirrhosis: diagnosis with sonographic study of the liver surface.Radiology 1989;172:389–393PubMedGoogle Scholar
  17. 17.
    Black WC. How to evaluate the radiology literature.AJR 1990;154:17–22PubMedGoogle Scholar
  18. 18.
    Departamento de Epidemiologia Clinica y Bioestadistica, Universidad de McMaster, Hamilton-Ontario, Canada. Como Leer Revistas Medicas. II. Para aprender sobre una prueba diagnostica.Rev Invest Clin Mex 1988;40:73–83Google Scholar
  19. 19.
    Maddrey WC. Hepatic vein thrombosis (Budd-Chiari syndrome).Hepatohgy 1984;4:44S-46SGoogle Scholar
  20. 20.
    Dodds WJ, Erickson SJ, Taylor AJ, Lawson TL, Stewart ET. Caudate lobe of the liver: anatomy, embryology and pathology.AJR 1990;154:87–93PubMedGoogle Scholar
  21. 21.
    NIH Conference. Hepatocellular carcinoma.Ann Intern Med 1988;108:390–401Google Scholar
  22. 22.
    Zoli M, Cordiani MR, Marchesini G et al. Ultrasonographic follow-up of liver cirrhosis.J Clin Ultrasound 1990;18:91–96PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1992

Authors and Affiliations

  • Hector Ferral
    • 1
  • Rene Male
    • 2
  • Mario Cardiel
    • 3
  • Luis Munoz
    • 4
  • Francisco Quiroz y Ferrari
    • 1
  1. 1.Department of RadiologyInstituto Nacional de la NutricionMexico D.F.Mexico
  2. 2.Department of GastroenterologyInstituto Nacional de la NutricionMexico D.F.Mexico
  3. 3.Department of Clinical EpidemiologyInstituto Nacional de la NutricionMexico D.F.Mexico
  4. 4.Department of PathologyInstituto Nacional de la NutricionMexico D.F.Mexico

Personalised recommendations