Ultrasonographic diagnosis of hepatic fibrosis or cirrhosis

Background/Aims: Evaluation of the degree of hepatic fibrosis is especially important in patients with chronic liver disease. Our aim was to study the diagnostic accuracy of abdominal ultrasonography for cirrhosis or fibrosis , Methods: Twenty-three clinical (n=12) and Doppler ultrasonic (n=11) variabl es were recorded in 243 patients,vith chronic (alcoholic and viral) liver d isease under conditions close to those of clinical practice, Fibrosis was c lassified into six grades by two pathologists, Diagnostic accuracy was eval uated by discriminant analysis, first globally using all variables, then by stepwise analysis. Results: A) Diagnosis of cirrhosis: 1) whole group (n=243): diagnostic accu racy was globally 84%, and 84% with two variables: spleen length, portal ve locity; 2) compensated chronic liver disease (n=191): diagnostic accuracy w as globally 85%, and 82% with two variables: liver surface, liver length (r ight kidney); 3) alcoholic compensated chronic liver disease (n=109): diagn ostic accuracy was globally 86%, and 88% with two variables: spleen length, liver length (middle clavicle); 4) viral compensated chronic liver disease (n= 83): diagnostic accuracy was globally 86% and 86% with one variable: l iver surface. By subtracting the proportion of patients who could not be in vestigated due to anatomical limitations, the highest calculated univariate diagnostic accuracy decreased by 7%, B) Diagnosis of fibrosis: diagnostic accuracy was globally 84% for extensive fibrosis. Conclusions: Cirrhosis can be correctly diagnosed in 82-88% of patients wit h chronic liver disease using a few ultrasonographic signs. However, the di agnostic accuracy of ultrasound is decreased by the anatomical limitations of this technique.