Sohail Saba, Aziz Sina', Mirza Talat
Department of Radiology, DMC/DUHS, Civil Hospital, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2013 Aug;23(8):548-52.
To determine the accuracy of ultrasound in the diagnosis and grading of steatosis and fibrosis in Hepatitis C (HCV) patients not responding to ribavarin-interferon therapy.
A cross-sectional, analytical study.
Radiology Department, Civil Hospital, Karachi, from March 2008 to August 2010.
Patients with positive HCV RNA despite 24 weeks ribavarin-interferon therapy (non-responders) were subjected to ultrasound and biopsy prior to institution of pegylated interferon therapy for detection and grading of steatosis and fibrosis. Using histopathology as the gold standard, sensitivity, specificity, negative and positive predictive values for ultrasound were determined.
The sensitivity of ultrasound for hepatic steatosis was 90.9% for no steatosis (NS), 100% for moderate and gross steatosis and 84.4% for mild steatosis with 100% specificity. The sensitivity for fibrosis was 25% for no fibrosis, 100% for mild fibrosis, 89.74% for moderate fibrosis and 100% for gross fibrosis. The overall accuracy for detection of steatosis was 95.39% and that for fibrosis was 98.02%. Hepatic vein showed increased dampening of flow with advancing grades of steatosis and fibrosis.
Ultrasound has a high accuracy in the diagnosis and grading of steatosis and fibrosis in HCV nonresponders. Mild fibrosis may confound the diagnosis of mild steatosis.
确定超声对利巴韦林 - 干扰素治疗无反应的丙型肝炎（HCV）患者脂肪变性和肝纤维化的诊断及分级的准确性。
横断面分析研究。
2008年3月至2010年8月，卡拉奇市民医院放射科。
尽管接受了24周的利巴韦林 - 干扰素治疗但HCV RNA仍为阳性的患者（无反应者），在接受聚乙二醇干扰素治疗之前接受超声检查和活检，以检测脂肪变性和肝纤维化并进行分级。以组织病理学作为金标准，确定超声的敏感性、特异性、阴性和阳性预测值。
超声对肝脂肪变性的敏感性，无脂肪变性（NS）为90.9%，中度和重度脂肪变性为100%，轻度脂肪变性为84.4%，特异性为100%。对肝纤维化的敏感性，无纤维化时为25%，轻度纤维化为100%，中度纤维化为89.74%，重度纤维化为100%。脂肪变性检测的总体准确率为95.39%，纤维化检测的总体准确率为98.02%。随着脂肪变性和肝纤维化程度的加重，肝静脉血流衰减增加。
超声对HCV无反应者脂肪变性和肝纤维化的诊断及分级具有较高的准确性。轻度纤维化可能会混淆轻度脂肪变性的诊断。
