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11. Non-Invasive Evaluation of Liver Fibrosis; Diagnostic Performance of Ultrasound Signs

Muhammad Saulat Nawaz1, Maria Nawaz1, Hasham Nawaz1, Syed Jawad Hussain2, Syed Amir Gilani3 and Muhammad Usama Faruqui4

ABSTRACT

Objective: To assess the diagnostic performance of Ultrasonography in evaluation of liver fibrosis.

Study Design: Prospective / observational study

Place and Duration of Study: This study was conducted at the Nawaz Medicare Hospital, Faisalabad during Jan 2019 to Dec 2020.

Materials and Methods: In this prospective observational study, 130 liver patients, 70 (53.84%) males and 60 (46.15%) females confirmed upon serological examination were included for their Ultrasonography investigations that had already undergone liver biopsy for diagnostic work-up of hepatopathy.  Liver nodularity was noted by studying echogenicity and echo pattern.  The caudate lobe hypertrophy was measured using 3.5 megahertz transducer at the level of portal vein bifurcation; and Anterior Posterior diameter of the lobe was measured between Inferior vena cava and ligamentum venousum. The portal venous as well as hepatic venous blood flow was recorded in Doppler studies to note vascular index towards the diagnosis of portal hypertension and fibrosis. The performance of various ultrasound signs was measured into different statistical parameters. The written informed consent of every patients was taken before collecting the data for research. The permission of Ethical Committee of the Nawaz Medicare hospital was taken before collecting the data and get publishing in the Medical Journal.

Results: The incidence of liver fibrosis in male patients was 70(53.84%) and in female patients was 60(46.15%). The incidence of Chronic HBV infection was 32(24.24%), in Chronic HCV infection was 93(76.23%) and Alcohol abuse was 5(4.10%). The incidence of fibrosis was present in 76(62.30%) and fibrosis was absent in 54(41.53%). The incidence of fibrotic patients was maximum 29(23.80%) in grade 1 and was minimum 12 (9.80%) in grade 4. The incidence of performance of various ultrasound signs in prediction liver fibrosis was maximum 83% accuracy, 76% sensitivity, 93% specificity in Abnormal Hepatic venous flow and was minimum 37% accuracy, 59% sensitivity, 0% specificity in abnormal vascular index. The incidence of diagnostic performance of the level of ultrasound signs presence in liver patients was 66% accuracy, 63% sensitivity, 72% specificity and 51% accuracy, 21%sentivity, 100% specificity.

Conclusion: The results were of the view that ultrasound might be seen as safe and non-invasive technique against liver biopsy for the diagnosis of liver fibrosis that may be considered accurate and sensitive but highly specific method.

Key Words: Non-invasive evaluation of liver fibrosis, Diffuse parenchymal liver disease, liver ultrasound, ultrasound signs.

Citation of article: Nawaz MS, Nawaz M, Nawaz H, Hussain SJ, Gilani SA, Faruqui MU. Non-Invasive Evaluation of Liver Fibrosis; Diagnostic Performance of Ultrasound Signs. Med Forum 2021;32(3):47-50.