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Ultrasound markers in early diagnosis of asymptomatic chronic hepatitis. A prospective study
Mihai Lazăr1, Ecaterina Constanţa Barbu2, Cristina Emilia Chiţu2
1MD, PhD, Department of Pathophysiology, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, and National Institute for Infectious Diseases "Prof. Dr. Matei Balș", 1 Dr. Calistrat Grozovici Street, Bucharest 021105, Romania.
Insights
Hilar liver adenopathies are a key noninvasive ultrasound marker for early detection of asymptomatic chronic viral hepatitis, aiding in diagnosis for hepatitis B and C patients.
Area of Science:
- Hepatology and Viral Hepatitis
- Medical Imaging and Diagnostics
- Public Health and Epidemiology
Background:
- Chronic viral hepatitis affects over 400 million globally, incurring high costs and leading to significant mortality.
- Late-stage complications and high mortality rates underscore the need for early diagnosis and cost-effective detection methods.
Purpose of the Study:
- To identify noninvasive ultrasound markers for the early diagnosis of asymptomatic chronic viral hepatitis.
- To evaluate the utility of specific ultrasound findings in differentiating between hepatitis B and C.
Main Methods:
- A prospective study involving 111 patients with asymptomatic chronic hepatitis (53 with hepatitis B, 58 with hepatitis C).
- Ultrasound examinations assessed liver lobe dimensions, portal vein size, liver stiffness, and the presence/characteristics of hepatic hilar lymph nodes (adenopathies).
Main Results:
- Adenopathies were detected in 64.16% of hepatitis B patients and 82.76% of hepatitis C patients.
- The long adenopathic axis demonstrated high negative predictive value (>0.9) and specificity (0.98) for both viral hepatitis types.
- Positive predictive values were 0.5 for hepatitis B and 0.9 for hepatitis C, with sensitivities of 0.64 (B) and 0.81 (C).
Conclusions:
- The presence of hepatic hilar adenopathies is a significant ultrasound marker for detecting asymptomatic chronic viral hepatitis.
- Ultrasound assessment of hilar adenopathies offers a valuable, noninvasive approach for early hepatitis diagnosis.
Introduction:
Nowadays, chronic viral hepatitis represents one of the most common pathological entities with over 400 million cases worldwide, with high diagnosis and treatment cost, severe complications in late stages and an annual death-rate around 1 million. The purpose of this study was to identify noninvasive ultrasound markers in order to establish an early diagnosis in asymptomatic chronic hepatitis.
Methods:
We enrolled in a prospective study 111 patients diagnosed with asymptomatic chronic hepatitis: 53 patients with hepatitis B (group A) and 58 patients with hepatitis C (group B). All patients underwent ultrasound exam; we evaluated the dimensions of the left hepatic lobe, right hepatic lobe, caudate lobe, portal vein, liver stiffness, presence of hepatic hilar lymph nodes, number and dimensions of the adenopathies.
Results:
Increased liver size was found in over 16% of patients in group A and over 20% of patients in group B. We registered an enlarged portal vein in 3.77% of patients in group A and in 3.45% of patients in group B. Adenopathies were found in 64.16% of group A and 82.76% of group B. Using long adenopathic axis as marker, we obtained a NPV over 0.9, PPV of 0.5 in the detection of chronic hepatitis B and a PPV of 0.9 in the detection of chronic hepatitis C in asymptomatic patients, a specificity of 0.98 for both chronic hepatitis B and C, a sensitivity of 0.81 for group B and 0.64 for group A.
Conclusions:
The presence of hilar liver adenopathies represents an important marker in detecting asymptomatic chronic viral hepatitis.
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