The diagnosis of cirrhosis: clinical relevance and methodology

Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis

“…In our study, spleen volume was increased in CVH and cirrhotic patients compared with the controls, which is consistent with the findings in other studies [19,20,22,[24][25][26][28][29][30][31]38] . It is well known that a relative interobser ver variability may limit the value for gray scale and Doppler ultrasonography [33][34][35][36] .…”

“…However, several studies [25,28] have questioned this because liver biopsies lead to false negative diagnoses of cirrhosis due to sampling errors in an estimated average of 24% pooled blind liver biopsy series [6] . Schalm [28] has reviewed the diagnostic methodology of liver cirrhosis and found that percutaneus liver biopsy has a sensitivity of below 85% in detection of liver cirrhosis.…”

“…However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations.…”

Computer-aided assessment of hepatic contour abnormalities as an imaging biomarker for the prediction of hepatocellular carcinoma development in patients with chronic hepatitis C

“…Several reports [19][20][21] have proposed that a disproportionate decrease in the portal blood flow or differences in the concentrations of various hormones, hepatotrophic factors, and nutrients in the regional portal blood can contribute to the morphologic changes of the cirrhotic liver. At ultrasonographic scanning, liver surface nodularity reflects the presence of the regenerative nodules and fibrous septa that are the essential histologic findings for the diagnosis of cirrhosis [10,22]. Colli et al [10,22] investigated the accuracy of various ultrasonographic signs to assess the degree of liver fibrosis, including surface nodularity and caudate lobe hypertrophy.…”

Noninvasive classification of liver disease in asymptomatic and oligosymptomatic male alcoholics

“…When indicated blindly, liver biopsies yielded on average 24% false-negative results (9), no evidence of necrosis or fibrosis was obtained for 40-50% of chronic alcoholics (10), and the procedure was associated with significant morbidity and with 0.015-0.03% mortality in other series (11,12). The costs of hospitalization and the discomfort imposed on the patients should also be considered.…”