Radiological Feature of Hepatic Cirrhosis in Hepatitis “C” in Pakistan; Our experience at Department of Radiology, Services Institute of Medical Sciences

Abstract

Objects: To evaluate the accuracy of liver fibrosis stage by utilizing the techniques of advanced
ultrasound performance in patients with chronic liver disease with Hepatitis C.
Material and Method: This cross-sectional study was prospectively designed by including 101
consecutive patients with a diagnosis of chronic liver disease including liver cirrhosis between
January and December 2010. The ultrasound score was determined from both hepatic lobes and
the average scoring was calculated for liver edge, liver surface and liver parenchymal texture. A
score of 0 was given when no abnormality was observed; score 1 for mild abnormality; score of 2
for moderate abnormality; and a score of 3 for severe abnormality. Scoring was given for a blunted
edge and severe irregular surface or a highly coarse texture only when these characteristics were
clearly confirmed by the low frequency probe.
Results: Out of 101 subjects, 63.4 % were male and 36.6 % were female with age range of.23-
70 years (mean age 50.73 years SD +/- 10). 17.8 % subjects were between age group 20-40
years, 67.3 % between age group 41- 60 years and 14.9 % between 61 years and above. Mean
duration of illness was 2.86 years (minimum 1 year and maximum 15 years). Mean liver size was
12.261 with SD + 2.7145. Mean portal vein size was 1.662 SD + 2.3247. Mean spleen size was
71.71 SD + 32.226. 62.4 % had splenomegaly, 66.3 % had ascites, 56.4 % had bruising and
bleeding, 62.4% had varices. 20.8 % had sharp edge 48.5 % had mildly blunted edge and 30.7 %
had blunt edge, 11.9% had smooth edge. 33.7% had mildly irregular edge, 39.6 % had irregular
edge and 14.9 % had highly irregular edge. Regarding liver parenchymal structure 13.9 % had
fine , 22.8 % had mildly coarse, 48.5 had coarse and 14.9 % had highly coarse liver parenchymal
structure.15.8 % of subjects had mild fibrosis (score 0 -2) , 55.4 % had moderate fibrosis (score 3 -
5) , 28.7 % had severe fibrosis (score 6 -8).
Conclusion: US scoring system is clinically useful for differentiating patients with minimal or no
fibrosis from those with mild to severe fibrosis. This is also useful for prognostic information and
determining the optimal therapeutic options during the follow-up of chronic liver disease