Ultrasonic diagnosis of cirrhosis: reference to quantitative measurements of hepatic dimensions

Hepatic echo patterns and "right lobe to left lobe longitudinal diameter ratio" were compared in age- and sex-matched 100 normal subjects and 76 patients with diffuse liver diseases (38 cirrhotics and 38 noncirrhotics) in a prospective sonographic study. Various echo patterns, assigned to cirrhotic livers (bright liver, micronodulation, beam attenuation), could not differentiate cirrhosis from other diffuse liver diseases. In cirrhotic livers, the right lobe manifested a significant shrinkage, while the left lobe exhibited almost no alteration. Considering the right to left lobe ratio of 1.30 as a discriminatory value, the cirrhosis could be diagnosed with a sensitivity of 74%, a specificity of 100%, and an accuracy of 93%; the sensitivity rates were seen to be higher in postnecrotic cirrhosis than in alcoholic cirrhosis.