Diagnostic value of hepatic vein ultrasound in early detection of liver cirrhosis

Background and Objective: Liver cirrhosis is a common disease that is the result of damage to liver cells with various etiologies. Diagnosis in most patients with cirrhosis occurs only in the late stages of the disease when hepatic failure develops. For this reason, only protective therapeutic measures are taken for these patients. Early diagnosis of cirrhosis can be effective in improving prognosis. Considering the availability and affordability of ultrasound throughout the world, in this study, the diagnostic value of hepatic vein ultrasound in early detection of cirrhosis of the liver was studied. Materials and Methods: In this experimental study, 45 patients who referred to the radiology department of Ghaem Hospital for liver biopsy were evaluated for changes in the hepatic veins under ultrasound with a transducer of 5-7 MHz in 2016. Patients whose pathology result was unavailable were excluded. One piece of hepatic vein was selected for ultrasound and the wall of hepatic veins was examined for straightness and uniformity of echogenicity. Subsequently, patients underwent biopsy by ultrasound guide. Three pathology slides were prepared from each sample and were identified by a pathologist. The ultrasound results of the patients in these two groups were matched with pathologic findings and the results were evaluated. The code of ethical approval is IR.MUMS.REC.1389.93. The results were analyzed using SPSS16 software. P<0.05 was considered as the level of significance. Results: In this study, 29 patients (64.4%) were male and 16 patients (35.6%) were female. In the pathologic examination, eight patients had mild chronic hepatitis without fibrosis, four patients with fatty liver and 33 patients had severe cirrhosis or chronic hepatitis with fibrosis. Overall, 33 patients (73.33%) had symptoms of cirrhosis due to the presence or absence of fibrosis, and 12 patients (26.64%) had no histopathologic symptoms of cirrhosis. The results showed that patients with hepatitis with or without fibrosis had irregular and wavy hepatic vein wall (impairment in straightness) with non-uniform echo (impairment in uniformity of echogenicity) and patients without hepatitis and cirrhosis, with fatty liver, had smooth and regular hepatic vein wall with a uniform echo (P<0.05, RR> 0.1). Conclusion: Our study showed that hepatic vein examination in terms of echogenicity and straightness can be used to diagnose hepatitis, its severity and its course towards fibrosis and cirrhosis.

Keywords:

Liver cirrhosis , straightness , uniformity of echogenicity , ultrasound , hepatic vein