Low-/high-frequency ultrasound study of liver parenchyma morphology to determine diagnostic utility for extent of liver fibrosis in patients with chronic hepatitis

• Main Author: LIN Jianling
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2013-05-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: ultrasonography; hepatitis B; chronic; liver cirrhosis
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=5348&ClassID=5416634

ObjectiveTo determine whether subtle changes in hyperechoic findings from low-/high-frequency ultrasound analysis of liver biopsy specimens from patients with chronic hepatitis correlate with differences in liver parenchyma morphology associated with presence and extent of fibrosis. MethodsSpatially-matched liver parenchyma biopsy specimens from 216 patients with chronic hepatitis (hepatitis b virus infection) were subjected to both low- and high-frequency ultrasound, as well as conventional histological analysis, which was used to score the extent of fibrosis (progressive staging: S1, no fibrosis, through S4, cirrhosis). The low- and high-frequency point-like echo and echo performance, respectively, were used to classify samples among one of five fractionating features (fine, thick, coarse/crude, irregular/nonlinear, cable stripes). Significance of intergroup differences was assessed by Chi-squared test. Spearman′s correlation coefficient was used to assess the correlation between the ultrasound findings and histological fibrosis stage. ResultsThe changes in echoic findings paralleled progressive deterioration in fibrosis stage: from fine to thicker, uneven, and cable stripe shapes along stages S0 to S4. Both the low- and high-frequency ultrasound findings could differentiate changes in liver parenchyma morphology associated with S1 (low-frequency: χ2=76.52 vs. S2, χ2=71.91 vs. S3, χ2=59.43 vs. S4; high-frequency: χ2=76.52 vs. S2, χ2=71.91 vs. S3, χ2=59.43 vs. S4; all P＜0.01) and S2 (low-frequency: χ2=5.17 vs. S3, χ2=21.25 vs. S4; high frequency: χ2=23.67 vs. S3, χ2=3480 vs. S4; all P＜0.01). There were no significant differences associated with either low- or high-frequency ultrasound findings for S3 or S4. The low- and high-frequency ultrasound liver parenchyma fractionation were postively correlated to liver fibrosis staging (r=04858 and r=0.5513, respectively). The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound (61.67% vs. 27.31%; χ2=49.96, P＜0.01), and the positive rates were positively correlated with liver fibrosis stage (low-frequency: r=0.5437; high-frequency: r=0.3021). ConclusionWhile both low- and high-frequency ultrasound allow for detection of liver fibrosis and differentiation of some fibrotic stages, the high-frequency ultrasound findings are superior for detecting fibrotic nodules.