Abstract
Hepatic steatosis and fibrosis produce abnormal echo patterns on ultrasound scanning, but the potential of ultrasound scanning for diagnosing these conditions in routine clinical practice is uncertain. A prospective comparative study of 85 patients with histologically assessed liver conditions was performed, and specificity was assessed in 76 patients with functional bowel disease who were presumed to have normal livers. Histological examination showed steatosis ranging from mild to severe in 48 patients and fibrosis ranging from increased fibrous tissue to established cirrhosis in 35 patients. Ultrasound scanning accurately identified steatosis, recognising 45 cases (sensitivity 94%) with a specificity of 84%. Fibrosis was less reliably detected (sensitivity 57% and specificity 88%). Of the 50 patients with alcoholic liver disease, 47 (94%) yielded abnormal results on scanning. In the 76 patients with functional bowel disease there was only one false positive result, giving a specificity of 99% in this group. As hepatic steatosis is the earliest change in alcoholic liver disease and seems to be of prognostic importance for the development of cirrhosis, ultrasound scanning provides an effective screening procedure, particularly in the occult alcoholic, who often presents with non-specific gastrointestinal complaints.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bernadt M. W., Mumford J., Taylor C., Smith B., Murray R. M. Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet. 1982 Feb 6;1(8267):325–328. doi: 10.1016/s0140-6736(82)91579-3. [DOI] [PubMed] [Google Scholar]
- Czaja A. J., Steinberg A. S., Saldana M., Marin G. A. Peritoneoscopy: its value in the diagnosis of liver disease. Gastrointest Endosc. 1973 Aug;20(1):23–25. doi: 10.1016/s0016-5107(73)73859-1. [DOI] [PubMed] [Google Scholar]
- Debongnie J. C., Pauls C., Fievez M., Wibin E. Prospective evaluation of the diagnostic accuracy of liver ultrasonography. Gut. 1981 Feb;22(2):130–135. doi: 10.1136/gut.22.2.130. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dewbury K. C., Clark B. The accuracy of ultrasound in the detection of cirrhosis of the liver. Br J Radiol. 1979 Dec;52(624):945–948. doi: 10.1259/0007-1285-52-624-945. [DOI] [PubMed] [Google Scholar]
- Foster K. J., Dewbury K. C., Griffith A. H., Wright R. The accuracy of ultrasound in the detection of fatty infiltration of the liver. Br J Radiol. 1980 May;53(629):440–442. doi: 10.1259/0007-1285-53-629-440. [DOI] [PubMed] [Google Scholar]
- Joseph A. E., Dewbury K. C., McGuire P. G. Ultrasound in the detection of chronic liver disease (the "bright liver"). Br J Radiol. 1979 Mar;52(615):184–188. doi: 10.1259/0007-1285-52-615-184. [DOI] [PubMed] [Google Scholar]
- Lawson T. L. Hepatic abscess: ultrasound as an aid to diagnosis. Am J Dig Dis. 1977 Jan;22(1):33–37. doi: 10.1007/BF01077394. [DOI] [PubMed] [Google Scholar]
- Levi A. J., Chalmers D. M. Recognition of alcoholic liver disease in a district general hospital. Gut. 1978 Jun;19(6):521–525. doi: 10.1136/gut.19.6.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lindsell D. R., Wilson A. G., Maxwell J. D. Fractures on the chest radiograph in detection of alcoholic liver disease. 1982 Aug 28-Sep 4Br Med J (Clin Res Ed) 285(6342):597–599. doi: 10.1136/bmj.285.6342.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maxwell J. D., Patel S. P., Bland J. M., Lindsell D. R., Wilson A. G. Chest radiography compared to laboratory markers in the detection of alcoholic liver disease. J R Coll Physicians Lond. 1983 Oct;17(4):220–223. [PMC free article] [PubMed] [Google Scholar]
- Mee A. S., McLaughlin J. E., Hodgson H. J., Jewell D. P. Chronic immune colitis in rabbits. Gut. 1979 Jan;20(1):1–5. doi: 10.1136/gut.20.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meek D. R., Mills P. R., Gray H. W., Duncan J. G., Russell R. I., McKillop J. H. A comparison of computed tomography, ultrasound and scintigraphy in the diagnosis of alcoholic liver disease. Br J Radiol. 1984 Jan;57(673):23–27. doi: 10.1259/0007-1285-57-673-23. [DOI] [PubMed] [Google Scholar]
- Scott W. W., Jr, Sanders R. C., Siegelman S. S. Irregular fatty infiltration of the liver: diagnostic dilemmas. AJR Am J Roentgenol. 1980 Jul;135(1):67–71. doi: 10.2214/ajr.135.1.67. [DOI] [PubMed] [Google Scholar]
- Taylor K. J., Gorelick F. S., Rosenfield A. T., Riely C. A. Ultrasonography of alcoholic liver disease with histological correlation. Radiology. 1981 Oct;141(1):157–161. doi: 10.1148/radiology.141.1.6270725. [DOI] [PubMed] [Google Scholar]
- Taylor K. J., Rosenfield A. T. Grey-scale ultrasonography in the differential diagnosis of jaundice. Arch Surg. 1977 Jul;112(7):820–825. doi: 10.1001/archsurg.1977.01370070034004. [DOI] [PubMed] [Google Scholar]
- Theodossi A., Spiegelhalter D., Portmann B., Eddleston A. L., Williams R. The value of clinical, biochemical, ultrasound and liver biopsy data in assessing patients with liver disease. Liver. 1983 Oct;3(5):315–326. doi: 10.1111/j.1600-0676.1983.tb00883.x. [DOI] [PubMed] [Google Scholar]