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AIM:To select valuable ultrasonographic predictors for theevaluation of hepatic inflammation and fibrosis degree inchronic hepatitis,and to study the value of ultrasonographyin the evaluation of liver fibrosis and compensated livercirrhosis in comparison with serology and histology.METHODS:Forty-four ultrasonographic variables wereanalyzed and screened using color Doppler ultrasoundsystem in 225 patients with chronic viral hepatitis andcompensated liver cirrhosis.The valuable ultrasonographicpredictors were selected on the basis of a comparison withhistopathological findings.The value of ultrasonography andserology in the evaluation of liver fibrosis degree and thediagnosis of compensated liver cirrhosis was also studiedand compared.Meanwhile,the influencing factors onultrasonographic diagnosis of compensated liver cirrhosiswere also analyzed.RESULTS:By statistical analysis,the maximum velocity ofportal vein and the degree of gall-bladder wall smoothnesswere selected as the valuable predictors for the inflammationgrade (G),while liver surface,hepatic parenchymal echopattern,and the wall thickness of gall-bladder were selectedas the valuable predictors for the fibrosis stage (S).ThreeS-related independent ultrasonographyic predictors and threeroutine serum fibrosis markers (HA,HPCⅢ and CIV) wereused to discriminate variables for the comparison ofultrasonography with serology.The diagnostic accuracy ofultrasonography in moderate fibrosis was higher than thatof serology (P<0.01),while there were no significantdifferences in the general diagnostic accuracy of fibrosis aswell as between mild and severe fibrosis (P<0.05).Therewere no significant differences between ultrasonography andserology in the diagnosis of compensated liver cirrhosis.However,the diagnostic accuracy of ultrasonography washigher in inactive liver cirrhosis and lower in active cirrhosisthan that of serology (both P<0.05).False positive and falsenegative results where found when the diagnosis ofcompensated liver cirrhosis was made by ultrasonography.CONCLUSION:There are different ultrasonographic predictors for the evaluation of hepatic infiammation gradeand fibrosis stage of chronic hepatitis.Both ultrasonographyand serology have their own advantages and disadvantagesin the evaluation of liver fibrosis and compensated livercirrhosis.Combined application of the two methods is hopefulto improve the diagnostic accuracy.
AIM: To select valuable ultrasonographic predictors for the evaluation of hepatic inflammation and fibrosis degree inchronic hepatitis, and to study the value of ultrasonography in the evaluation of liver fibrosis and compensated liver cirrhosis in comparison with serology and histology. METHODS: Forty-four ultrasonographic variables wereanalyzed and screened using color Doppler ultrasounds system in 225 patients with chronic viral hepatitis and compensated liver cirrhosis. The valuable ultrasonographic predictors were selected on the basis of a comparison with histopathological findings. the value of ultrasonography andserology in the evaluation of liver fibrosis degree and the diagnosis of compensated liver cirrhosis was also studiedand compared.Meanwhile, the influencing factors onultrasonographic diagnosis of compensated liver cirrhosiswere also analyzed .RESULTS: By statistical analysis, the maximum velocity ofportal vein and the degree of gall-bladder wall smoothnesswere selected as the valuable pr edictors for the inflammationgrade (G), while liver surface, hepatic parenchymal echopattern, and the wall thickness of gall-bladder were selectedas the valuable predictors for the fibrosis stage (S). ThhsS-related independent ultrasonography predictors and threeroutine serum fibrosis markers (HA , HPC III and CIV) were used to discriminate variables for the comparison ofultrasonography with serology. The diagnostic accuracy ofultrasonography in moderate fibrosis was higher than that of serology (P <0.01), while there were no significantdifferences in the general diagnostic accuracy of fibrosis aswell as between mild Severe fibrosis (P <0.05). Therewere no significant differences between ultrasonography andserology in the diagnosis of compensated liver cirrhosis. Despite, the diagnostic accuracy of ultrasonography washigher in inactive liver cirrhosis and lower in active cirrhosisthan that of serology (both P <0.05) .False positive and falsenegative results where found when the diagnosis ofcompen sated liver cirrhosis was made by ultrasonography. CONCLUSION: There are different ultrasonographic predictors for the evaluation of hepatic infiammation grade and fibrosis stage of chronic hepatitis. Both ultrasonography and serology have their own advantages and disadvantages in the evaluation of liver fibrosis and compensated liver cirrhosis. Combined application of the two methods is hopefulto improve the diagnostic accuracy.